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I have left off the Sources, Misc., list of amendments’ listings, and other such stuff, since anyone wanting to read them can go to the source.


Title 38: Pensions, Bonuses, and Veterans' Relief


PART 21—VOCATIONAL REHABILITATION AND EDUCATION

Subpart A—Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31


Independent Living Services


§ 21.160 Independent living services.

(a) Purpose. The purpose of independent living services is to assist eligible veterans whose ability to function independently in family, community, or employment is so limited by the severity of disability (service and nonservice-connected) that vocational or rehabilitation services need to be appreciably more extensive than for less disabled veterans.

(Authority: 38 U.S.C. 3104(a)(15), 3109, 3120)

(b) Definitions. The term independence in daily living means the ability of a veteran, without the services of others or with a reduced level of the services of others, to live and function within the veteran's family and community.

(Authority: 38 U.S.C. 3101(2))

(c) Situations under which independent living services may be furnished. Independent living services may be furnished:

(1) As part of a program to achieve rehabilitation to the point of employability;

(2) As part of an extended evaluation to determine the current reasonable feasibility of achieving a vocational goal;

(3) Incidental to a program of employment services; or

(4) As a program of rehabilitation services for eligible veterans for whom achievement of a vocational goal is not currently reasonably feasible. This program of rehabilitation services may be furnished to help the veteran:

(i) Function more independently in the family and community without the assistance of others or a reduced level of the assistance of others;

(ii) Become reasonably feasible for a vocational rehabilitation program; or

(iii) Become reasonably feasible for extended evaluation.

(Authority: 38 U.S.C. 3104(a)(15), 3109, 3120)

(d) Services which may be authorized. The services which may be authorized as part of an IILP (Individualized Independent Living Plan) include:

(1) Any appropriate service which may be authorized for a vocational rehabilitation program as that term is defined in §21.35(i), except for a course of education or training as described in §21.120; and

(2) Independent living services offered by approved independent living centers and programs which are determined to be necessary to carry out the veteran's plan including:
(i) Evaluation of independent living potential;

(ii) Training in independent living skills;

(iii) Attendant care;

(iv) Health maintenance programs; and

(v) Identifying appropriate housing accommodations.

(Authority: 38 U.S.C. 3104(a)(15), 3109, 3120)

(e) Coordination with other VA elements and other Federal, State, and local programs. Implementation of programs of independent living services and assistance will generally require extensive coordination with other VA and non-VA programs. If appropriate arrangements cannot be made to provide these services through VA, other governmental, private nonprofit and for-profit agencies and facilities may be used to secure necessary services if the requirements contained in §21.294 are met.

(Authority: 38 U.S.C. 3104(a)(15), 3109, 3115, 3120)
[49 FR 40814, Oct. 18, 1984, as amended at 53 FR 50957, Dec. 19, 1988; 55 FR 42186, Oct. 18, 1990]


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Title 38: Pensions, Bonuses, and Veterans' Relief


PART 21—VOCATIONAL REHABILITATION AND EDUCATION

Subpart A—Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 


Independent Living Services

§ 21.162 Participation in a program of independent living services.

(a) Approval of a program of independent living services. A program of independent living services and assistance is approved when:

(1) The VA determines that achievement of a vocational goal is not currently reasonably feasible;

(2) The VA determines that the veteran's independence in daily living can be improved, and the gains made can reasonably be expected to continue following completion of the program;

(3) All steps required by §§21.90 and 21.92 of this part for the development and preparation of an Individualized Independent Living Plan (IILP) have been completed; and

(4) The VR&E Officer concurs in the IILP.

(Authority: 38 U.S.C. 3104(a)(15), 3109, 3120)

(b) Considerations for the VR&E Officer. The VR&E Officer will consider the following factors in administering programs providing independent living services:

(1) If VA resources available limit the number of veterans who may be provided a program of independent living services and assistance, the first priority shall be given to veterans for whom the reasonable feasibility of achieving a vocational goal is precluded solely as a result of service-connected disability; and

(2) To the maximum extent feasible, a substantial portion of veterans provided with programs of independent living services and assistance shall be receiving long-term care in VA medical centers and nursing homes.

(Authority: 38 U.S.C. 3120(c))
[49 FR 40814, Oct. 18, 1984, as amended at 53 FR 50957, Dec. 19, 1988; 55 FR 48842, Nov. 23, 1990; 62 FR 17708, Apr. 11, 1997]



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Title 38: Pensions, Bonuses, and Veterans' Relief


PART 21—VOCATIONAL REHABILITATION AND EDUCATION

Subpart A—Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31


Case Status


§ 21.192 “Independent living program” status.

(a) Purpose. The independent living program status serves to:
(1) Identify veterans who are being furnished a program of independent living services by VA; and
(2) Assure that such veterans receive necessary services from VA in a timely manner.
(b) Assignment to independent living program status. A veteran may be assigned or reassigned to independent living program status under the provisions of §§21.88, 21.94, 21.96, or 21.98.
(Authority: 38 U.S.C. 3107)

(c) Continuation in independent living program status. A veteran will be in independent living program status during periods in which:

(1) The provisions of §21.282 for induction into a program are met, but the veteran is pending induction into the facility at which rehabilitation services will be provided;

(2) The veteran receives rehabilitation services prescribed in an IILP; or

(3) The veteran is on authorized leave of absence status.

(Authority: 38 U.S.C. 3109, 3120)

(d) Termination of independent living program status. When a veteran's case has been assigned to independent living program status, the case will be terminated from that status, if one of the following occurs:

(1) A veteran, who has been notified of necessary arrangements to begin a program, the date the program begins and instructions as to the next steps to be taken:

(i) Fails to report and does not respond to followup contact by the case manager;

(ii) Declines or refuses to enter the program; or

(iii) Defers entry for more than 30 days beyond the scheduled beginning date, unless the deferment is due to illness or other sufficient reason.

(2) The veteran completes the IILP;

(3) Either the veteran or VA interrupts the program;

(4) Either the veteran or VA discontinues the program; or

(5) Service-connection for the veteran's service-connected disability is severed by VA or he or she otherwise ceases to be eligible.

(Authority: 38 U.S.C. 3109, 3110)Cross-References:

See §§21.160 Independent living services, 21.282 Effective date of induction into a rehabilitation program, 21.322 Commencing date, and 21.324 Reduction or termination date.

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NOTE: There are additional sections noted in the above two. They can be explored, but I felt they did not impact this topic enough to be printed here.

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Title 38: Pensions, Bonuses, and Veterans' Relief


PART 21—VOCATIONAL REHABILITATION AND EDUCATION 

Subpart A—Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31

Duration of Rehabilitation Programs

§ 21.76 Independent living.

(a) General. A program of independent living services may be authorized to enable the veteran to:

(1) Reach the goals of the program, and

(2) Maintain the newly achieved level of independence in daily living.

(Authority: 38 U.S.C. 3101(4), 3104(b))

(b) Period of independent living services. The duration of an independent living services program may not exceed 24 months unless the counseling psychologist finds that an additional period of up to 6 months would enable the veteran to substantially increase his or her level of independence in daily living. The concurrence of the Vocational Counseling and Rehabilitation Officer in this finding is required.

(Authority: 38 U.S.C. 3105(d))
[49 FR 40814, Oct. 18, 1984, as amended at 54 FR 37332, Sept. 8, 1989]

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Title 38: Pensions, Bonuses, and Veterans' Relief


PART 21—VOCATIONAL REHABILITATION AND EDUCATION 

Subpart A—Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31

Individualized Written Rehabilitation Plan

§ 21.90 Individualized independent living plan.

(a) Purpose. The purpose of the IILP is to identify the steps through which a veteran, whose disabilities are so severe that a vocational goal is not currently reasonably feasible, can become more independent in daily living within the family and community.

(Authority: 38 U.S.C. 3109, 3120)

(b) Elements of the plan. The IILP shall follow the same structure as the IWRP. The plan will include:

(1) Services which may be provided under Chapter 31 to achieve independence in daily living;

(Authority: 38 U.S.C. 3104)

(2) Utilization of programs with a demonstrated capacity to provide independent living services for severely handicapped persons;

(Authority: 38 U.S.C. 3104(b), 3120(a))

(3) Services provided under other Department of Veterans Affairs and non-Department of Veterans Affairs programs needed to achieve the goals of the plan;

(Authority: 38 U.S.C. 3107)

(4) Arrangements for maintaining the improved level of independence following completion of the plan.

(Authority: 38 U.S.C. 3107(a))

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Title 38: Pensions, Bonuses, and Veterans' Relief

PART 21—VOCATIONAL REHABILITATION AND EDUCATION

Subpart A—Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31


Rate of Pursuit

§ 21.310 Rate of pursuit of a rehabilitation program.

(d) Rehabilitative services. Measurement of the rate of pursuit for veterans in programs consisting primarily of services designed to evaluate and improve physical and psychological functioning will be assessed under this paragraph.

(1) The services assessed under this paragraph include:

(i) Evaluation and improvement of the rehabilitation potential of a veteran for whom attainment of a vocational goal is reasonably feasible;

(ii) Extended evaluation to determine whether attainment of a vocational goal is reasonably feasible; or

(iii) A program of independent living services to enable a veteran to function more independently in his or her family and community when attainment of a vocational goal is not reasonably feasible.

(2) Measurement of the rate of pursuit for services and programs named in paragraph (d)(1) of this section will be:

(i) As provided in paragraph (a) of this section for services furnished by educational institutions; or

(ii) According to the noneducational facility's customary criteria for full-time and part-time pursuit. If the facility does not have established criteria for full-time and part-time pursuit, or services are being provided by more than one facility, the rate of pursuit will be assessed in the following manner:

Rate of pursuit---Clock hours per month
Full-time---120 or more.
Three-quarter time1---90–119.
Half-time1---60–89.
Quarter-time1---30–59.

1Extended evaluation and independent living.



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Office of the Law Revision Counsel, U.S. House of Representatives


38 USC Sec. 3107 02/01/2010

TITLE 38 - VETERANS' BENEFITS

PART III - READJUSTMENT AND RELATED BENEFITS

CHAPTER 31 - TRAINING AND REHABILITATION FOR VETERANS WITH SERVICE-CONNECTED DISABILITIES

Sec. 3107. Individualized vocational rehabilitation plan

(a) The Secretary shall formulate an individualized written plan of vocational rehabilitation for a veteran described in section 3106(b) of this title. Such plan shall be developed with such veteran and shall include, but not be limited to

(1) a statement of long-range rehabilitation goals for such veteran and intermediate rehabilitation objectives related to achieving such goals,

(2) a statement of the specific services (which shall include counseling in all cases) and assistance to be provided under this chapter,

(3) the projected date for the initiation and the anticipated durationof each such service, and

(4) objective criteria and an evaluation procedure and schedule for determining whether such objectives and goals are being achieved.



(b) The Secretary shall review at least annually the plan formulated under subsection (a) of this section for a veteran and shall afford such veteran the opportunity to participate in each such review. On the basis of such review, the Secretary shall

(1) redevelop such plan with such veteran if the Secretary determines, under regulations which the Secretary shall prescribe, thatredevelopment of such plan is appropriate, or

(2) disapprove redevelopment of such plan if the Secretary determines, under such regulations, that redevelopment of such plan is not appropriate.



(c)(1) Each veteran for whom a plan has been developed or redeveloped under subsection (a) or (b)(1), respectively, of this section or in whose case redevelopment of a plan has been disapproved under subsection (b)(2) of this section, shall be informed of such veteran's opportunity for a review as provided inparagraph (2) of this subsection.

(2) In any case in which a veteran does not agree to such plan as proposed, to such plan as redeveloped, or to the disapproval of redevelopment of such plan, such veteran may submit to the person described in section 3106(f) of this title a written statement containing such veteran's objections and request a review of such plan as proposed or redeveloped, or a review of the disapproval of redevelopment of such plan, as the case may be.

(3) The Secretary shall review the statement submitted under paragraph (2) of this subsection and the plan as proposed or as redeveloped, and, if applicable, the disapproval of redevelopment of the plan, and render a decision on such review not later than ninety days after the date on which such veteran submits such statement, unless the case is one for which a longer period for review, not to exceed 150 days after such veteran submits such statement, is allowed under regulations prescribed by the Secretary, in which case the Secretary shall render a decision no later than the last day of the period prescribed in such regulations.

Office of the Law Revision Counsel, U.S. House of Representatives


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Office of the Law Revision Counsel, U.S. House of Representatives

38 USC Sec. 3109 02/01/2010

TITLE 38 - VETERANS' BENEFITS

PART III - READJUSTMENT AND RELATED BENEFITS

CHAPTER 31 - TRAINING AND REHABILITATION FOR VETERANS WITH SERVICE-CONNECTED DISABILITIES

Sec. 3109. Entitlement to independent living services and assistance

In any case in which the Secretary has determined under section 3106(e) of this title that the achievement of a vocational goal by a veteran currently is not reasonably feasible, such veteran shall be entitled, in accordance with the provisions of section 3120 of this title, to a program of independent living services and assistance designed to enable such veteran to achieve maximum independence in daily living.

Office of the Law Revision Counsel, U.S. House of Representatives


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38 USC Sec. 3105 02/01/2010

TITLE 38 - VETERANS' BENEFITS

PART III - READJUSTMENT AND RELATED BENEFITS

CHAPTER 31 - TRAINING AND REHABILITATION FOR VETERANS WITH SERVICE-CONNECTED DISABILITIES

Sec. 3105. Duration of rehabilitation programs

(d)(1) Except as provided in paragraph (2), the period of a program of independent living services and assistance for a veteran under this chapter (following a determination by the Secretary that such veteran's disability or disabilities are so severe that the achievement of a vocational goal currently is not reasonably feasible) may not exceed twenty-four months.

(2)(A) The period of a program of independent living services and assistance for a veteran under this chapter may exceed twenty-four months as follows:

(i) If the Secretary determines that a longer period is necessary and likely to result in a substantial increase in the veteran's level of independence in daily living.

(ii) If the veteran served on active duty during the Post-9/11 Global Operations period and has a severe disability (as determined by the Secretary for purposes of this clause) incurred or aggravated in such service.

(B) In this paragraph, the term "Post-9/11 Global Operations period" means the period of the Persian Gulf War beginning on September 11, 2001, and ending on the date thereafter prescribed by Presidential proclamation or by law.


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Office of the Law Revision Counsel, U.S. House of Representatives

38 USC Sec. 3120 02/01/2010

TITLE 38 - VETERANS' BENEFITS

PART III - READJUSTMENT AND RELATED BENEFITS

CHAPTER 31 - TRAINING AND REHABILITATION FOR VETERANS WITH SERVICE-CONNECTED DISABILITIES

Sec. 3120. Program of independent living services and assistance

(a) The Secretary may, under contracts with entities described in subsection (f) of this section, or through facilities of the Veterans Health Administration, which possess a demonstrated capability to conduct programs of independent living services for severely handicapped persons, provide, under regulations which the Secretary shall prescribe, programs of independent living services and assistance under this chapter, in various geographic regions of the United States, to veterans described in subsection (b) of this section.

(b) A program of independent living services and assistance may be made available under this section only to a veteran who has a serious employment handicap resulting in substantial part from a service-connected disability described in section 3102(1)(A)(i) of this title and with respect to whom it is determined under section 3106(d) or (e) of this title that the achievement of a vocational goal currently is not reasonably feasible.

(c) The Secretary shall, to the maximum extent feasible, include among those veterans who are provided with programs of independent living services and assistance under this section substantial numbers of veterans described in subsection (b) of this section who are receiving long-term care in Department of Veterans Affairs hospitals and nursing homes and in nursing homes with which the Secretary contracts for the provision of care to veterans.

(d) A program of independent living services and assistance for a veteran shall consist of such services described in section 3104(a) of this title as the Secretary determines necessary to enable such veteran to achieve maximum independence in daily living. Such veteran shall have the same rights with respect to an individualized written plan of services and assistance as are afforded veterans under section 3107 of this title.

(e) Programs of independent living services and assistance shall be initiated for no more than 2600 (!1) veterans in each fiscal year, and the first priority in the provision of such programs shall be afforded to veterans for whom the reasonable feasibility of achieving a vocational goal is precluded solely as a result of a service-connected disability.

(f) Entities described in this subsection are

(1) public or nonprofit agencies or organizations, and

(2) for-profit entities in cases in which the Secretary determines that services comparable in effectiveness to services available from such an entity are not available, or cannot be obtained cost-effectively from, public or nonprofit agencies or through facilities of the Veterans Health Administration.


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38 USC Sec. 3104 02/01/2010

TITLE 38 - VETERANS' BENEFITS

PART III - READJUSTMENT AND RELATED BENEFITS

CHAPTER 31 - TRAINING AND REHABILITATION FOR VETERANS WITH SERVICE-CONNECTED DISABILITIES

Sec. 3104. Scope of services and assistance

(a) Services and assistance which the Secretary may provide under this chapter, pursuant to regulations which the Secretary shall prescribe, include the following:

(1) Evaluation, including periodic reevaluations as appropriate with respect to a veteran participating in a rehabilitation program, of the potential for rehabilitation of a veteran, including diagnostic and related services (A) to determine whether the veteran has an employment handicap or a serious employment handicap and whether a vocational goal is reasonably feasible for such veteran, and (B) to provide a basis for planning a suitable vocational rehabilitation program or a program of services and assistance to improve the vocational rehabilitation potential or independent living status of such veteran, as appropriate.

(2) Educational, vocational, psychological, employment, and personal adjustment counseling.

(3) An allowance and other appropriate assistance, as authorized by section 3108 of this title.

(4) A work-study allowance as authorized by section 3485 of this title.

(5) Placement services to effect suitable placement in employment, and postplacement services to attempt to insure satisfactory adjustment in employment.

(6) Personal adjustment and work adjustment training.

(7)(A) Vocational and other training services and assistance, including individualized tutorial assistance, tuition, fees, books, supplies, handling charges, licensing fees, and equipment and other training materials determined by the Secretary to be necessary to accomplish the purposes of the rehabilitation program in the individual case.

(B) Payment for the services and assistance provided under subparagraph (A) of this paragraph shall be made from funds available for the payment of readjustment benefits.

( Loans as authorized by section 3112 of this title.

(9) Treatment, care, and services described in chapter 17 of this title.

(10) Prosthetic appliances, eyeglasses, and other corrective and assistive devices.

(11) Services to a veteran's family as necessary for the effective rehabilitation of such veteran.

(12) For veterans with the most severe service-connected disabilities who require homebound training or self-employment, or both homebound training and self-employment, such license fees and essential equipment, supplies, and minimum stocks of materials as the Secretary determines to be necessary for such a veteran to begin employment and are within the criteria and costlimitations that the Secretary shall prescribe in regulations for the furnishing of such fees, equipment, supplies, and stocks.

(13) Travel and incidental expenses under the terms and conditions set forth in section 111 of this title, plus, in the case of a veteran who because of such veteran's disability has transportation expenses in addition to those incurred by persons not so disabled, a special transportation allowance to defray such additional expenses during rehabilitation, job seeking, and the initial employment stage.

(14) Special services (including services related to blindness and deafness) including -

(A) language training, speech and voice correction, training in ambulation, and one-hand typewriting;

(B) orientation, adjustment, mobility, reader, interpreter, and related services; and

(C) telecommunications, sensory, and other technical aids and devices.

(15) Services necessary to enable a veteran to achieve maximum independence in daily living.

(16) Other incidental goods and services determined by the Secretary to be necessary to accomplish the purposes of a rehabilitation program in an individual case.


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38 USC Sec. 3106 02/01/2010

TITLE 38 - VETERANS' BENEFITS

PART III - READJUSTMENT AND RELATED BENEFITS

CHAPTER 31 - TRAINING AND REHABILITATION FOR VETERANS WITH SERVICE-CONNECTED DISABILITIES

Sec. 3106. Initial and extended evaluations; determinations regarding serious employment handicap

(d) In any case in which the Secretary has determined that a veteran has a serious employment handicap and also determines, following such initial and any such extended evaluation, that achievement of a vocational goal currently is not reasonably feasible, the Secretary shall determine whether the veteran is capable of participating in a program of independent living services and assistance under section 3120 of this title.

(e) The Secretary shall in all cases determine as expeditiously as possible whether the achievement of a vocational goal by a veteran currently is reasonably feasible. In the case of a veteran provided extended evaluation under subsection (c) of this section (including any periods of extensions under section 3105(a) of this title), the Secretary shall make such determination not later than the end of such extended evaluation or period of extension, as the case may be. In determining whether the achievement of a vocational
goal currently is reasonably feasible, the Secretary shall resolve any reasonable doubt in favor of determining that such achievement currently is reasonably feasible.

These are comments given throughout VBN on many different topics concerning ILP. I know I have probably missed a LOT of good informative replies, but hopefully, this will give a halfway decent idea of what you face entering the ILP program. I have changed them in minor ways…the context is still there, just edited a little.


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Santosha1

Title 38 USC 3120...gives us an understanding as to why the program is in affect in some regions and not others...also, this law states ILP is open to 2600 veterans per fiscal year...


Here I am, once again ticked off by laws that leave a Veteran at the mercy of making things "clear as mud"....geez wasn't that sweet of them to open ILP to 2600 Vets, vs 2500and why is the program extended for a 24 month period to Vets who only served after 9/11... this is so wrong.


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71Infantry


the Independent learning program is a small part of the Vocational Rehabilitaion program.

It is generally reserved to those veteans that are rated 100% or TDIU.

It can result in schooling for any number of things from college, to computer classes and Independent living skills.

It can also be used for home remodeling for those who were not granted the adapted housing grant, or have used the adapted housing grant in the past and have moved.

Some veterans might get power tools, computers and printers, and camera equipment.

Each program is designed to the needs of the veteran.

No two programs are the same.

The most important thing is to have a counselor who understands the program, and is willing to work to meet the needs of the veteran.

In my opinion, and in my experience there are very few counselors that are knowledgeable about the ILP or who are willing to work to see a veteran gets what he needs.

The program is not spelled out in any great detail in any va publication that I have ever reviewed.

That is, the specifics are not widely published. It is one of the va's best kept secrets.

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Ilyanir

I was placed in the Independent Living Program which seeks to help disabled veterans live more independently and integrate more into society instead of staring at four walls all day long.

What you receive from the program differs from veteran to veteran but what they tell you in the beginning does not.

I was told my very first meeting that they only do handrails, assistive devices, bath mats, etc. and I called bullshit. I've had to fight for everything that I've received but I've gotten the items I asked for.

You have to give them a reason for getting the item, how it will benefit you, i.e. help you integrate further into society, how it's success can be measured progress wise, etc.

I was told that they don't do laptops, yet I eventually received one after fighting them over the issue.

The biggest thing is that you have to show how it's going to benefit your service connected issues, improve your quality of life and how its help for you can be measured as you progress in the program.


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Gunny1169

It really depends on your counselor and local VR&E

...how educated your counselor is key to the success of your ILP....

I've been going through the process almost a year and still haven't receive all the quality of life needs the home assessment contractor requested...

it a long cumbersome process....

you'll need to have a lot of patience....

and you'll have to do a lot of the leg work for your needs requested...

.you have to have 3 quotes/estimates for the quality of life items...

.the counselor will write up an Individual ILP and

it will have to be approved by their supervisor...

.just remember patience and don't give up the fight


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Santosha1

You're gonna find a ton of contradictions in this program.

I researched this starting with the statutory law that governs the program, and this is where the problems is...

the law is very vague and leaves pretty much each region to implement as they see fit.

ILP is not a program to get you back to work. The Voc Rehab program is the program that is available to train Veterans for jobs that can sustain while dealing with SC disabilities.

The ILP programs falls under the Voc Rehab program...for instance in 2005 I was denied Voc Rehab and I was offered ILP, I refused ILP because I didn't need no "stinkin'" help to live life...rofl.

When I applied for ILP I had to meet with a Voc Rehab counselor first...

they then kick your application over to ILP. This is my experience.

So first stop is applying for the program,

then comes an appt with a Voc Rehab counselor,

then an ILP counselor.


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USNDW

you all need to go ahead and put an application in right now for VR&E.

If he gets an appointment and goes to the assessment and they deny him educational or employment opportunities like they did me, if he doesn't have IU at that time, that denial letter from VR&E may be very helpful.

If they do happen to have a program he is eligible for, it does not mean he cannot get IU, but it may be something that will help.

If not, then you can request to go the ILP route if they do not mention it. The counselor I had in Kansas City did not even finish the assessment. She stopped me about halfway through and said I would not be able to do any of the programs, and then she started me on the track for ILP.

I think come counselors, who don't know anything about it, won't tell you anything about it.

Like 1SG said, it is not easy, but the only easy day was yesterday.


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Bluesixx

I have been reading everyones posts and preparing for what to expect. I see the lack of any type of standardization throughout the regions. I will certainly post as we go through the steps and keep everyone informed-we are in the southeast(transplants).


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Ilyanir

they want to provide you with a good or service that will benefit you and that you won't get fed up with, bored with or be unable to use it entirely or something that will further hinder or hurt your condition(s), etc. What you need to do is find something that you enjoy and that you think would enable you to have something to do around the house, etc. that will help fill your day and provide you with mental stimulation and possibly help you get up and about.


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Provenpioneers

You must apply to Voc Rehab first and be disqualified from it and put in a ILP


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(Santosha1)

“4) Did you all know you're suppose to have a VA Social Worker assigned to manage your "case"....kinda quarterback things for you? I didn't and so that is something we are establishing now.”


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brianwl

The thing about the ILP program is there is no hard and fast that one has to be 100% or even unable to work.

Example:

A person who can work but has physical disabilities requiring their home or car to be modified would get ILP to have those mods done.


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Climber

Keep in mind, the IL program is supposed to address your "needs" to meet your activities of daily living, not provide a hobby.

However, if an item like a camera will help reduce the symptoms of your service-connected disability, Chapter 31 may be able to help.

Some veterans with depression or PTSD have found that items like a camera help them get out of the house, engage in a meaningful activity, and to not isolate...this can help improve their mental health symptoms.

The length of an IL plan will vary depending on the issues it is addressing.

As soon as the objectives of an IL plan are met, the Voc Rehab Counselor will reassess you to determine if it is "currently reasonably feasible" for you to acheive a vocational goal.

If they determine that it is feasible, they will have to redevelop your plan to include services that lead to the acheivement of a vocational goal, i.e. education or training.

There is no $25,000.00 for IL. The amount spent on an IL plan will vary with each case depending on your needs...

If you already have a service dog, the Chapter 31 should not need to help. If you have a dog that you would like to be trained to be a service dog, then it can be done in the IL program...

30% for hearing loss represents a significant hearing impairment, they will likely address that.


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Ilyanir

they want to provide you with a good or service that will benefit you and that you won't get fed up with, bored with or be unable to use it entirely or something that will further hinder or hurt your condition(s), etc.

What you need to do is find something that you enjoy and that you think would enable you to have something to do around the house, etc. that will help fill your day and provide you with mental stimulation and possibly help you get up and about.

AND

in addition to making your life easier you need to be thinking about things that you enjoy doing and that would enable you to be more involved in the community.

An example would be if you like to paint they can provide you with art classes and supplies, etc. so that you can paint and exhibit your work. Painting, drawing, etc. has been shown to be therapeutic in nature.

In my case I asked for a musical instrument as music therapy is a proven treatment for PTSD and depression.

You need to be thinking outside of the box in terms of what you might like to do to help pass the time and that won't interfere with your disabilities and enable you to more fully integrate into your family and community.

There are some guys that have received wood working tools, i.e. complete shops so that they would have something to help pass the time, develop fine motor skills and enable them to interact with others. etc.

You just need to determine what you need to improve your quality of life and what you might enjoy.

I got a lift chair that raises up, vibrates and has heat, etc. and am supposed to be going to the pain management clinic to see if hydrotherapy will benefit my back pain, etc. If they deem that I can benefit from the hydrotherapy for my inflammation, arthritis, pain, etc. from my joints and back I have been told they can approve a personal, portable hot tub.

There are many options you just need to read up on the program and try to get the benefits that will help you the most in your personal case.


*******************

USNDW

The main thing is have a plan or goal why you want certain items.

Once you read about ILP, and do like I have done here, ask a hundred questions you will learn more.

I think the main factors are Safety in his surroundings, like I am asking for an electric range to replace our gas one, I have accidentally turned the gas on 2x, and left it on once.

Quality of life, being able to enjoy his life. I am going to ask for some fishing equipment because my buddies keep trying to take me fishing,

I am also going to ask for a wii for me and my family for entertainment we can share and do together.

A laptop so I can research and learn about VA benefits so I can try to volunteer in the near future at a Veteran organization.

Just think of those kind of things and how it will make a positive impact on his life. If he gets approved, then your a couple of steps ahead of the game.


***********************

Gunny1169

....your home assessment will take about 2 - 4 hours...the contractor will take a week or two to submit the report to VRE....

VRE will set-up another meeting to discuss report and to start developing a IILP....(your plan for ILP)....remember this ILP is a 24 month program...it can be extended additional 6 months...

It takes awhile before you actually will receive any quality of life needs...your looking at another 3 - 6 months...

I stay in contact with my ILP counselor by email....its really worked well for me.


**********************

Ilyanir

When he or she shows up they will most likely already have reviewed your case file and know to a certain degree what you limitations are.

From there you will talk about what you need in terms of help around the house to make it more easily accessible, what you can have to overcome issues such as PTSD, etc.

You need to know that in addition to assistive devices they are supposed to address your avocational needs, i.e. what you enjoy doing and what stuff they could provide you that will keep you from staring at four walls all day and going crazy, etc.


***************************

Bluesixx

We had our home visit today, it took about 3 hours.

We all sat at the table and went through hubby's medical record, as our contractor wanted a full picture of his limitations.

We talked about various areas that she believed could be improved via the ILP.

Then she went down the list of limitations, actually suggested solutions, we concurred with most of her suggestions, she then began composing a written list.

We added a couple of requests.

Amazingly she suggested nearly all the items we were hoping to request and some we had not even thought of.

Our contractor was wonderful. She is an RN by trade. She was very kind, professional, knowledgeable and offered words of encouragement too. Geez, I wanted to hug her!

Hubby's limitations are results of frontal lobe issues with processing speed, concentration, comprehension, memory etc, chronic pain-both knees, and sleep issues.

As the list goes...

*Pill Box with voice reminders
*Railings at the front entrance way
*An Orthopedic Type Reclining Chair
*Some type of orthopedic mattress topper that has 4 units that can be arranged to accommodate various sleep positions.
*Sleep Apnea Pillow
*Laptop & some specialized software programs
*Computer Desk with a large Ergonomic Chair
*PDA/GPS
*A Jetted Tub
*Lawnmower and cart

She said Hubby would be scheduled soon to meet with his counselor on the "plan" but that she was putting in for the some of the items immediately and those items should only take a couple of months. The rest she said may take up to six months (or longer ;-).

I am expecting it to take the full length of the program and I realize all the items may not be approved however, so far so good, right?

The one thing (I will have to speak with Hubby and get further clarification; I had left for a doctors appointment about a half of an hour before she did), I do not believe had been discussed/addressed, is ways to get him out of isolation/the house due to the MDD and anxiety.


***************************

Gunny1169

Bluesixx....sounds like a good home assessment ....

next step....you and the VRE will get a copy of the report in a week or two....

your assisted living items recommended by the ILP contractor will be reviewed, approved or denied by a VRE Review Panel in another couple of weeks...

.so your looking at another month or so before your ILP counselor will set-up another meeting with you to discuss your home assessment and begin your ILP Plan VA Form 28-6872...

.after you and the ILP counselor discuss your home assessment report...the counselor can start to order your quality of life needs.

Remember if you don't agree with any part of ILP.... request to meet with the ILP counselor's supervisor or the supervisor's boss until you get a clear understanding....

it never hurts to get more than one opinion...

Please be patient because the program takes time to develop and each veteran plan is a little different from another....


*************************

Ilyanir


The $25,000 is the amount that can be authorized at the local level at the VR&E office before having to go to the next higher level.

I totally disagree with the VR&E offices’ obvious attempts to substitute, misinform, items of lessor value in an obvious attempt to save money.

There are some that will argue this point but the ILP program is an "ENTITLEMENT" just as the Chapter 31 Voc Rehab program is.

Many veterans aren't afforded the opportunity to go through the Chpt. 31 portion and sent straight to the ILP program.

If they had been afforded the Chpt. 31 option the cost of books, tuition, supplies would have been in excess of $100,000+ dollars at todays current tuition / book rate, etc.

Even if they granted every person they deny the Cpt. 31 program the $75,000 at the higher levels of authorization they would still be realizing a savings. I speak from experience from my dealings with my regional office.

I was told that instead of a keyboard / piano that I could use "Music Software" with my laptop that would help me with music therapy when it was an obvious effort to reduce the cost of my plan.

They tried to play hard ball and I fought back.

My piano and all the equipment I received for help with music therapy for my PTSD / Depression cost around $5,000.

The software that would not meet my needs, etc. that was trying to be forced down my throat was only going to cost them around $200 to $500 at the most.

It's criminal the amount of abuse that veterans are having to put up with and the obstacles that are placed in our path in this program.

The program is supposed to help you be more self reliant / independent, but it's also supposed to address "AVOCATIONAL" goals which is strictly interpreted as items such as hobbies you enjoyed that give you self worth, something to do, etc. to keep you from staring at four walls all day long and withering away.

This needs to stop.


**********************

USNDW

This process stresses me out like everyone else. Maybe you can approach this as a game, and each level of the VA you reach is a new milestone?

I would write a letter in response to your counselors asking why is there an ILP program? And why is it that he cannot recommend any one product or service to help you?

If your MH keeps you from interacting with other people, maybe you need to point that out to him, and then ask if he is trying to give you medical advice about your service connected condition.

Try to get out of him what products he has recommended or purchased in the past for other Veterans with MH. Inquire as much as you can, and if you can find out that he doesn't recommend anything for ILP Veterans, maybe he should go find another line of work?

If you see your VE doctor on a regular basis, ask them for ideas for products and services that would help you with mental stimulation. One of the products I recommended to my counselor was a Wii because it offered an opportunity for mental stimulation, and they approved it, but I had bought one already and didn't get the approval until after 14 months anyway. Ilyanir said that music was therapeutic. Ask your doc and see if he can give you any ideas and then ask if they can purchase those things.

Also ask your doc if doing what the ILP counselor is recommending. Should you be trying to become in activities outside your home, especially volunteer where you will be relied on for a long period of time? If they say no, ask them to write a short memo and send it to the counselor.

My initial counselor kept talking about the same crap. He thought I should get into a meaningful activity, like volunteering for the VA. I kept telling him I could not, that is why I was awarded TDIU, because some days I can't get out of the house. I know the problem with these counselors is they have no idea what they are doing, but if they are recommending Veterans to perform activities that can worsen their conditions, they might want to pick up a application at the nearest Wal-Mart.

March 24, 1993 M28-1, Part II
Change 7
CONTENTS
CHAPTER 8. PROGRAM OF INDEPENDENT LIVING SERVICES
PARAGRAPH PAGE

8.01 Introduction 8-1

8.02 Program Description 8-1

8.03 Eligibility for Participation 8-2

8.04 Scope of Services 8-3

8.05 Duration and Limitation of Services 8-3

8.06 Monetary Assistance 8-4

8.07 Travel 8-5

8.08 Procurement of Services 8-6

8.09 VHA⎯VR&C Linkage 8-8

8.10 Role of the Counseling Psychologist 8-9

8.11 Role of Vocational Rehabilitation Panel 8-10

8.12 Individualized Independent Living Program 8-11

8.13 Assignment of Case Status for Program Participants 8-12

8.14 Evaluations for Persons With TBI (Traumatic Brain Injury) 8-12
Rescinded by M28.IV.iii, June 8, 2006



July 22, 1992 M28-1, Part II
Change 5

CHAPTER 8. PROGRAM OF INDEPENDENT LIVING SERVICES

8.01 INTRODUCTION

a. General. A veteran may have disabilities BO severe that achievement of a vocational goal is not currently reasonably feasible. VA may provide this veteran with IL (independent living) services. These services will help the veteran either to reach the point where a vocational goal is reasonably feasible, to reach the point where it may be reasonably feasible for the veteran to participate in an extended evaluation, or to become more independent in daily living within his or her family and community.

b. Authority. A program of IL Services and assistance is authorized under 38 CFR 21.162.

8.02. PROGRAM DESCRIPTION

a. The Achievement of a Vocational Goal Is Not Currently Reasonably Feasible. To establish that it is not currently reasonably feasible for a veteran to achieve a vocational goal, a CP (counseling psychologist) must find that the veteran’s disabilities currently affect his or her employability to either of the following extents:

(1) The veteran cannot participate in a program of vocationally oriented training and services; or

(2) The veteran is able to successfully pursue vocational training, but it would be highly improbable for the veteran to obtain and retain employment consistent with his or her abilities, aptitudes, and interests.

b. Reasons for Authorizing a Program of IL Services. The VR&C (Vocational Rehabilitation and Counseling) Division may authorize a program of IL services for eligible veterans for whom achievement of a vocational goal is not currently reasonably feasible. This program of rehabilitation services may be furnished to help the veteran to

(1) Function more independently in his or her family and community without the assistance of others or with a reduced level of assistance from others;

(2) Become reasonably feasible for an extended evaluation; or

(3) Become reasonably feasible for a vocational rehabilitation program.

c. Independent Living and Independence in Daily Living. Independence in daily living means the ability of a veteran, either without the services of others or with a reduced level of those services, to live and function within the veteran’s family and community. Operationally, independent living is synonymous with independence in daily living.

d. Program of IL Services and Assistance. A program of IL services and assistance may include the following benefits:

(1) The services provided in 38 CFR 21.35(d), including the counseling, diagnostic, medical, social, psychological, and educational services which the CP determines the veteran needs to achieve maximum independence in daily living;

(2) The subsistence allowance and other monetary assistance authorized by 38 CFR 21.260, 21.262, 21.266, and 21.270; and

(3) The special rehabilitation services under 38 CFR 21.150, 21.152, 21.154, 21.155, and 21.156.

e. Barriers to Independent Living. The goal of an IL program is to increase the veteran’s options, resulting in an improved quality of life. options may be limited by skill deficits or by physical, environmental, or psychological factors. For example, some veterans may be able to overcome certain cognitive limitations through training intended to improve problem-solving. Some independent living program participants may need to learn how to manage personal care attendants, use adaptive equipment, and shop for necessities. For others, technological devices such as motorized wheelchairs or vehicle modifications may facilitate independent living. Supportive services, e.g., attendant care and health maintenance programs, may ameliorate the physical factors which increase the veteran’s dependence on others. Architectural modifications and advocacy to promote disabled persons, rights to barrier-free access may reduce environmental problems. Peer and professional counseling may decrease psychological hindrances to independence. A disabled veteran’s anxiety about discharge from an institution may diminish through interaction with other disabled persons who are successfully adjusting to community living.

f. Independent Living Services and the Rehabilitation Process. The goal of the IL program is not necessarily that the disabled veteran be able to live alone in the community with no supportive services. Rather, the goal is for that individual to have the skills necessary to choose an acceptable life-style and then be able to manage it with as little reliance on others as possible. in some instances, however, the veteran may require continuing services beyond completion of the IL program to maintain the level of independence achieved during the program. (See par. 8.05b below for limitations on these long-term services.)

8.03. ELIGIBILITY FOR PARTICIPATION

To be eligible for a program of IL services, VA must determine that

a. The veteran meets the basic eligibility and entitlement criteria for participation in a rehabilitation program;

b. Achievement of a vocational goal is not currently reasonably feasible;

c. The veteran has IL needs; and

d. The achievement of an IL goal is currently feasible; that is, VR&C staff members expect the IL services proposed will enable the veteran to live independently in his or her family and community or with reduced dependence upon the services of others.

8.04 SCOPE OF SERVICES

VA may provide a discrete service or a comprehensive program of services necessary to achieve maximum independence in daily living. As part of an IL program, the only vocational courses which VA may provide are those incidental to achieving intermediate IL objectives. Some of the IL services which VA may authorize are listed below:

a. Training in activities of daily living;

b. Training in IL skills;

c. Attendant care during a period of transition (see par. 8.05b below);

d. Transportation when special arrangements are required due to the disabling condition;

e. Peer counseling;

f. Evaluation or training in an IL program;

g. Housing (group, transitional, or housing specifically designed to meet the needs of disabled persons);

h. Advocacy; and

i. other services which 38 CFR 21.160 authorizes.

8.05 DURATION AND LIMITATION OF SERVICES

A program of IL services will not exceed the period necessary to restore independence in daily living. The duration of a program will not exceed 24 calendar months except as indicated in subparagraphs a and b below.

a. Extension for 6 Months. The CP may approve an extension of a program of IL services for up to 6 months if the additional period is necessary and should result in an increase in independence. The CP must carefully document in the veteran’s CER (Counseling/Evaluation/Rehabilitation) folder specifically how the additional services should lead to the desired results. No program may exceed 30 months.

b. Limitation of Selected Services. Some IL needs identified during the initial phase of program planning for a veteran may require services following completion of the program and, in some cases, for the rest of the veteran’s life. For example, the veteran might have a life-long need for a personal care attendant and for transportation assistance. Since the time a veteran can participate in the program is limited, program planning must focus on ways to meet these continuous needs following IL program participation. Vocational rehabilitation program funding for long-term needs is limited to the IL program period. During IL program participation the case manager will attempt to secure sources which will continue the assistance beyond the completion of the program. In no instance, however, may the VR&C Division provide these services beyond the maximum 30 months for an IL program.

c. Reentrance Following Rehabilitation and Discontinuance

(1) Reentrance Following a Determination of Rehabilitation. Under the conditions specified in 38 CFR 21.284(b), the CP may set aside a previous finding of rehabilitation following a program of independent living services and provide an additional period of independent living services.

(2) Reentrance Following Discontinuance. Under 38 CFR 21.76, a veteran discontinued from a program of independent living services may reapply (38 CFR 21.198(c)) and VA may authorize an additional period of up to 24 months of independent living services.

8.06 MONETARY ASSISTANCE

VA will pay subsistence allowance to a veteran in the IL program under 38 CFR 21.260.

a. Basis for Subsistence. Measure participation on a clock-hour basis. Pay subsistence allowance based on the number of clock hours spent in training directly related to the acquisition of IL skills—such as money management, personal care attendant management, and household maintenance. To measure the rate of pursuit, follow the instructions in 38 CFR 21.310(d).

(1) Reduced Work Tolerance. In view of the severity of the conditions of IL program participants, the CP must determine whether the veteran is entitled under reduced work tolerance (38 CFR 21.312) to a higher rate of subsistence allowance than VA would otherwise pay for a given level of participation.

(2) Limitations on Traditional Medical Therapies. Participation in traditional medical therapies (e.g., occupational therapy, psychotherapy, and physical therapy) will not typically be counted as training time although the case manager will document participation on the veteran’s VA Form 28-8872, Rehabilitation Plan.

b. Inpatient Status. VA may pay a subsistence allowance to veterans who are inpatients in a VA medical center or hospital at VA expense under 38 CFR 21.266 (a). The determination of rate of pursuit is the same as for veterans not hospitalized at a VA medical center.

c. Specialized Rehabilitation Facility. If the veteran is living in a specialized rehabilitation facility, VA can pay room and board expenses in lieu of basic subsistence allowance (38 CFR 21.266(b)). Even though VA pays the cost of room and board, the veteran will be paid the portion of subsistence allowance otherwise payable for dependents. For example, a veteran is entitled to subsistence allowance of $486, including $153 for dependents, but a decision has been make to have VA pay for room and board. The case manager would adjust the veteran’s award to withhold $333 and pay the remaining $153.

d. Bars to Payment of Subsistence Allowance. VA will not pay a subsistence allowance when a veteran participates at less than quarter time. When a veteran’s IILP (individualized independent living plan) provides for a period during which the veteran is receiving only supportive services and medical therapies, but no training, VA will not pay subsistence allowance under the IL program. This restriction includes periods during which the veteran is receiving only personal attendant care or a special transportation allowance.

e. Entitlement Usage and Program Length. VA will calculate charges against entitlement as for other chapter 31 programs measured in clock hours. In contrast, the VR&C Division will determine program duration (see par. 8.05 above) as the actual number of calendar months elapsed since the date the veteran first received services authorized on the IILP. This means, for example, that for a veteran who began receiving IL services at a half-time rate on January 3, 1987, and to whom the VA granted a 6-month extension, the IL program could not extend beyond July 2, 1989.

8.07 TRAVEL

a. Suitable Facility Not Locally Available. A suitable facility for the provision of IL services may not be available within the jurisdiction of the local regional office. In this case, VR&C staff members may apply the travel policies in 38 CFR 21.372 and the interregional transfer policies in part I, paragraph 13.02 if a suitable facility can be found outside the office’s jurisdiction and the veteran agrees to travel to that facility. When the nature of a veteran’s disability requires special travel accommodations, the VR&C Division should arrange for the payment of actual necessary travel expenses to the facility (see MP-1, pt. II, chs. 2 and 3).

b. Special Transportation Allowance. Under 38 CFR 21.154, VA may pay a special transportation allowance under a contractual agreement to a training facility or directly to a program participant if the participant has expenses commuting to the facility which a person without a disability would not need or incur. The CP will determine the need for a special transportation allowance. VA may pay for mileage, driver, parking fees, transportation furnished by the facility for its clients, and other valid expenses. The veteran must maintain a record of these costs. If VA will pay the transportation allowance directly to the veteran, the veteran will maintain a record of his or her transportation costs on Standard Form 1164, Claim for Reimbursement for Expenditures or Official Business. The case manager will certify the correctness of the claimed expenses and submit the form to the Finance Division for payment. VA will pay the lesser of the amounts under subparagraphs (1) and (2) below unless the veteran qualifies for the exception in subparagraph (3).

(1) Facility Provides Transportation. If the facility provides transportation which the veteran could reasonably use, but the veteran elects to travel by alternative means, VA will not pay more for transportation than the amount the facility charges other disabled persons for its transportation service.

(2) Maximum Payment Tied to Subsistence Allowance Rate. The maximum amount VA may pay for transportation expenses during any 1 month may not exceed one-half of the subsistence allowance for a single veteran at the full-time institutional rate or the actual cost, whichever is less.

(3) Exception. As an exception, VA may pay the full cost of extraordinary expenses—such as transportation by ambulance—which are essential to enable a veteran to pursue the program.

8.08. PROCUREMENT OF SERVICES

a. Authorization of Services and Supplies. The case manager will authorize the services, incidental goods, and supplies necessary for the veteran to accomplish the goals of an IL program. For these authorizations, the case manager will follow the policies and procedures in part III, chapters 2 and 6. If the case manager anticipates that program charges will require the approval of the Director, Vocational Rehabilitation Service, the regional office should follow the procedures in part II, chapter 3 to make a specific request to obtain approval of costs.

b. Approved Service Providers. Normally VR&C Divisions will use VA facilities to provide IL services to veterans participating in the program. If the VR&C Division cannot make timely, effective, and cost-efficient arrangements for VA facilities to provide these services, then the VR&C Division may follow the procedures described below and use other public, private nonprofit, and for-profit facilities.

(1) Use of VA Facilities. VA medical facilities are likely to be the best resources for VR&C Divisions to obtain authorized services as either part or all of an IILP. If these services are not available through VA medical facilities or the VR&C Division cannot make appropriate arrangements to timely use these facilities, the CP will document this in the veteran’s record:

(a) The record must summarize consultation with VHA (Veterans Health Administration) medical staff members concerning the need for medical, dental, and prosthetic services, including prosthetic aids, assistive devices, or medically related equipment. This requirement will be minimally met if a completed VA Form 28-8861, Request for Medical Services—Chapter 31, is in the veteran’s record. In item 11 of this form, the CP will identify the services requested and the questions to be answered by VHA staff members. The documentation must include the VHA response.

(b) The record must explain why a VA medical facility cannot provide or approve on a fee basis any needed nonmedical service. To document these reasons, the CP will use VA Form 28-1902b, Counseling Record Narrative Report, and, if needed, VA Form 28-1902n, Counseling Record Narrative Report (Supplemental Sheet). The VRS (vocational rehabilitation specialist) case manager will use VA Form 28-1905d, Special Report of Training.

(2) Use of For-profit and Nonprofit Facilities. VR&C Divisions may contract with other government, public, and private nonprofit and for-profit facilities or organizations to provide a program of IL services. VR&C Divisions may contract with for-profit agencies only if one of the following conditions is met:

(a) The VR&C Division cannot obtain comparable services through VA or other public and private nonprofit agencies; or

(b) The VR&C Division cannot obtain comparable services cost-effectively through VHA or other public or private nonprofit agencies.

c. Use of Consultants. VR&C staff members may use outside consultants to evaluate either a proposed program of services or an ongoing program to determine if the services proposed or being delivered will allow the veteran to reach the intended IL program goals.

(1) Use of Independent Contractors to Assess Services and Service Providers. If a VR&C Division contracts with an individual or facility, nonprofit or for-profit, to assess a veteran’s feasibility or needs for IL services, then the VR&C Division may not contract with that individual or facility to provide the recommended services. Similarly, an individual or facility under contract may assess the ability of IL service providers to cost-effectively provide a program of IL services for a particular veteran. The VR&C Division may not then award this individual or facility a contract to provide IL services to the veteran. These restrictions are designed to ensure an objective analysis of service needs and service providers.

(2) No Restriction on Services to Other Veterans. Even if an individual or facility assesses a veteran’s IL needs or the ability of service providers to support a veteran’s IL program, the VR&C Division may still contract with the assessor to provide IL services to chapter 31 participants other than the veteran for whom the assessment was made.

(3) Sole Source Providers. Veterans may live in an area which contains only one IL service provider. In these cases, either the VR&C Division, another VA or governmental agency, or a contractor from outside the area must perform the assessment of the veteran’s needs and the ability of the sole local service provider to deliver the needed services. Non-VR&C assessors must clearly establish that they have the expertise and experience in IL and the disabilities which cause the need for IL services. For veterans in these sole source situations, the needs assessment must also contain an analysis of the veteran’s ability to transfer to another area to receive IL services.

d. Contracting for IL Services. To contract for services provided by institutions as part of or the whole of an IL plan, VR&C staff members will follow the procedures described in part III, paragraph 2.02.

e. Use of Individual Instructors. Approved institutional service providers discussed in subparagraph d above, and not individual instructors, will usually provide the services detailed on the IILP. VA may use qualified individual instructors, however, when necessary in either of the following instances:

(1) To provide services incidental to the total IL program if the instructors are under contract to an approved service provider, or

(2) To provide a discrete service or services which VR&C staff members personally supervise. The service or services must be incidental to a total IL program. To approve this individual instruction, VR&C staff members must follow the procedures provided in Part III, paragraph 2.02.

8.09 VHA⎯VR&C LINKAGE

a. Referrals From VHA. if VHA staff members identify a veteran for possible participation in the IL program, they will refer the case to the VR&C Officer in the regional office of jurisdiction. VHA staff members should obtain a completed VA Form 28-1900, Disabled Veterans Application for Vocational Rehabilitation, and supporting medical evidence. This documentation should accompany the referral.

b. Coordination With VHA. If a veteran is receiving care in a VHA facility or it is anticipated that he or she will need VHA services, the CP must consult with appropriate VHA staff members during the development of the IILP to assure that VA formulates a single, coordinated plan for the veteran. The CP will forward a copy of the completed plan and all subsequent redevelopments of the plan to these VHA staff members.


8.10 ROLE OF THE COUNSELING PSYCHOLOGIST

a. Identification of Veterans. The CP must review each case in which a vocational goal is not currently reasonably feasible to determine if a program of IL services may be furnished for one of the reasons in subparagraph 8.02b above. if an IL program is feasible, the CP and the veteran must then develop a program of IL services that addresses the veteran’s needs. If a VRS will act as case manager, the VRS will also take part in the plan development (see subpar. 8.12b(1) for detailed instructions on who will act as case manager for IL programs).

b. Provision of IL Services When a Vocational Goal Is Feasible. When establishing a veteran’s entitlement to services under chapter 31, the CP must document in the CER folder why the achievement of a vocational goal is not currently reasonably feasible. If vocational rehabilitation is currently reasonably feasible, but the veteran is prevented from participating in a traditional vocational rehabilitation program due to deficient IL skills, the CP should integrate the needed IL services into an IWRP (individualized written rehabilitation plan). The case manager will arrange for these services as a preliminary part of the plan or concurrently with educational or vocational services.

c. Determination of Feasibility for Program of IL Services. In evaluating clients for inclusion in the program of IL services, the CP must determine that it is reasonable to expect an increase in the veteran’s level of independent functioning if the veteran receives these services.

(1) Documentation of the IL feasibility determination must be clearly evident in the record of each veteran for whom an IL program is provided.

(2) Outside consultants and the VRP (Vocational Rehabilitation Panel) are recommended for use as the providers of data to support the IL feasibility determination (see subpar. 8.08c above for details concerning the use of an outside consultant, and par. 8.11 below for use of VRP).

(3) When using an outside consultant or the VRP, the CP must assure that either resource has the expertise to address the needs of the veteran under consideration.

d. Denial of IL Services. If the CP determines that the achievement of a vocational goal is not currently reasonably feasible and the CP does not approve a program of IL services, the CP must obtain the VR&C Officer’s concurrence in the decision (21 CFR 21.53(f)). If the VR&C Officer does not concur, the CP must work with the VRS case manager and the veteran to develop a plan of IL services.


8.11 ROLE OF VOCATIONAL REHABILITATION PANEL

a. Use of the VRP. The CP may refer IL cases to the VRP on a voluntary basis for technical and consultation services (see 38 CFR 21.62). The VRP may be of particular assistance in helping the CP determine whether the veteran meets the following program participation criteria:

(1) The achievement of a vocational goal currently is not reasonably
feasible;

(2) The veteran exhibits the potential for IL services to cause a favorable change in critical functions—for example, mobility, self-care, and communication—which will most likely result in a positive change in eliminating or reducing the veteran’s dependence on others;

(3) The veteran possesses the physical, emotional, and intellectual capacity or potential to carry out the demands of an IL program;

(4) Any deterioration of the veteran’s disability is not significantly more rapid than the rehabilitation process; and

(5) The veteran is motivated to achieve IL goals.

b. Referral to VRP. For each veteran referred to the VRP for program consideration, the CP will prepare a memorandum through the VR&C Officer to the chairperson of the VRP. This memorandum will contain the following information:

(1) A summary of pertinent medical history, including a clear description of the veteran’s present functional limitations and strengths;

(2) A statement describing the bases for previous CP determinations that a vocational goal was not currently reasonably feasible;

(3) A statement of the veteran’s present IL needs;

(4) The specific IL objectives to be achieved while the veteran is a program participant as well as the potential service resources to reach those objectives; and

(5) other facts, observations, or opinions which may assist the VRP.

c. Vocational Rehabilitation Panel’s Recommendations. The CP will consider the VRP’s recommendations as expert technical assistance to facilitate effective decisionmaking and rehabilitation planning. Recommendations and suggestions by the VRP are not binding, but the CP may not disregard them without thorough consideration and documentation.



March 24, 1993 M28-1, Part II
Change 7

(1) Recommendation for Program of IL Services. After evaluating the referral, if the VRP finds that an IL goal is currently reasonably feasible for the veteran, the VRP will recommend the veteran’s inclusion in the program. The VRP may also recommend specific IL objectives and services for the CP to include in the IILP.

(2) Negative Recommendation. If the VRP finds that an IL goal is not currently reasonably feasible, the VRP will recommend that the VR&C Division not place the veteran in the program. Whenever possible following a negative recommendation, the VRP will suggest an integrated set of activities and services to improve the veteran’s condition so that later entry into the IL program may become feasible.

(3) Additional Information Needed. If the VRP needs additional information to make a recommendation regarding the feasibility of a program of IL services, the VRP may return the case to the CP and request development.

8.12 INDIVIDUALIZED INDEPENDENT LIVING PROGRAM

a. Development of IILP. The IILP facilitates a team approach in planning, coordinating, and implementing an interdisciplinary program of resources and services. Whenever appropriate, the CP will consult with the VRP and other rehabilitation personnel in developing the plan. Consequently, the IILP will organize and synthesize the information developed in the initial evaluation and any extended evaluation with the recommendations of the VRP and other rehabilitation professionals. The CP has primary responsibility for the formulation of the plan. Development of the IILP will follow the procedures for preparing an IWRP.

b. Implementation and Periodic Review of IILP

(1) Case Management Responsibilities. Normally, the CP is responsible for case management in implementing the IILP and monitoring the veteran’s progress. The CP will apply the basic procedures for providing assistance to the veteran and supervising the rehabilitation program to ensure timely implementation of the plan’s objectives. If using CPs as case managers for IL programs disrupts or delays delivery of services to other chapter 31 participants, the VR&C Officer may assign this IL role to a VRS. When a VRS is assigned an IL case, a CP should be available for consultation.

(2) Plan and Progress Reviews. The case manager and the veteran will review and evaluate the plan and the veteran’s progress toward the program goal as often as necessary—but at least once every 6 months—following the procedures and schedules outlined in the IILP for each objective. The case manager may use an outside consultant to assist in assessing this progress. On the basis of these reviews, the CP will determine whether to redevelop, amend, or retain the present plan.

c. Veteran’s Involvement

(1) IILP Development. The CP will solicit the veteran’s cooperation in negotiating and agreeing to the terms of the IILP. When the CP and the veteran have developed, agreed to, and documented the plan’s substantive terms, the CP and the veteran will sign the plan to indicate mutual understanding and acceptance of the terms. Unless a VRS will assume case management responsibilities, there will be only two signatures on the IILP. The veteran will receive a copy of the signed plan.

(2) Disagreement About Terms of IILP. If the CP and veteran cannot agree on the terms of the plan, the CP will request that the VR&C Officer review the proposed plan. The VR&C Officer will resolve the disagreement and ensure that plan development continues.

(3) Rights of Review and Appeal. The veteran or his or her representative may request administrative review of a proposed original or amended rehabilitation plan (see pt. I, par. 3.05). Within 1 year of written notification of the CP’s decision regarding the veteran’s plan, the veteran or his or her representative may appeal the terms of the proposed plan to BVA (Board of Veterans Appeals) by filing a notice of disagreement (see pt. I, ch. 10). VR&C staff members will inform the veteran that any administrative review must take place prior to appealing the decision to BVA. Once the veteran files a notice of disagreement, the VR&C Officer must immediately stop any administrative review in progress and begin appellate processing.

8.13 ASSIGNMENT OF CASE STATUS FOR PROGRAM PARTICIPANTS

For instructions regarding case status assignment of IL program participants, see part I, chapter 7.

8.14 EVALUATIONS FOR PERSONS WITH TBI (TRAUMATIC BRAIN INJURY)
Rescinded by M28.IV.iii, June 8, 2006



APPENDIX 8A

Directory of Rehabilitation Medicine Services
That Will Provide TBI Evaluations
for Chapter 31 Participants

VAMC RMS CONTACT* FTS NUMBER

1. Albany, NY Dr. Emma Aliwalis, Chief 641-2416
2. Albuquerque, NM Dr. Charles Kunkel, Chief 572-7015
3. Boston, MA Dr. Kyung-Ae Hahn, Chief 839-4981
4. Dallas, TX Dr. Kenneth Cole, Chief 749-5351
5. Chicago, IL (Hines) Mr. Robert Massey, Coordinator 381-4912
6. Houston, TX Dr. Trilok N. Nonga, Chief 528-7117
7. Knoxville, IA Mr. Andrew Hazer, Coordinator 861-5015
8. Long Beach, CA Mr. Jack Tomich, Coordinator 966-5958
9. Memphis, TN Mr. Glenn Ramsey, Coordinator 222-5381
10. Milwaukee, WI Dr. Mary Mantione, Chief 363-1103
11. Minneapolis, MN Ms. Deborah Monickon, RN 780-3566
12. Northport, NY Mr. Dennis Lawn, Coordinator 663-7198
13. Palo Alto, CA Dr. Elaine Date, Chief 463-5469
14. San Juan, PR Dr. Benigno Fernandez, Chief 804-766-6533
15. Seattle, WA Dr. Eugen M. Halar, Chief 396-2222
16. Tampa, FL Mr. John Strugar, Coordinator 822-6069



*The RMS contacts on this list will likely change. In the event someone on the list is not available, contact the Chief, RMS.

App. 8A- 1

USNDW wrote:

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It's funny that when I ask the VR&E officers at the RO questions about these instructions, they have no idea.

Crazy how we can access and read these guidelines and instructions within a few minutes, and these VA counselors who have worked for the VE for 20+ years have no idea what the Hell I am talking about when I start inquiring about the administration of the program.

I asked why do they provide Veterans products and services? What was the lenght of the program? How much was the allowance for ILP Veterans every year? What kind of services could be granted to help with Daily activities? Products or services that would benefit the Veteran and family? How are these products obtained? Who authorizes the final plan? How often do they do an assessment? What if we disagree on one item? Who was qualified to receive subsistance allowance?

They even told me that my travel to and from the VR&E for counseling was not reimbursable. It is reimbursable exactly like a C&P exam. No $3 deduction, no distance required. When I asked for a copy of the instruction stating that I could not be reimbursed, they just stopped returning my phone calls, and e-mails.

Initially when I walked into the VR&E they told me that they had nothing to do with the ILP program, and even after I handed the counselor a copy of the VA website page that stated the Veteran had to apply for VR&E before being accepted, he still refused to acknowledge they were responsible for it. CRAZY MAN, CRAZY!

USNDW,
I just posted in its own topic that GAO report on VR&E. http://vets.yuku.com/topic/49048

After reading that (while working it) it seems there are not all that many qualified people working the program. That's probably why you got someone who didn't have a clue.

I posted this because it might enlighten people as to what they are up against when trying to find trained personnel to help them through the system.

Can't hurt to be alert.

fanaticbooks

The actual forms don't show up anywhere, except the 28-8872 and 28-1095m. I also found the 28-1902w and 28-1900.

Well, maybe a copy will appear somehow. Even a photocopy or scanned document. If I can read it then I can at least mention what would be asked. I'll wait on the ones found to see if I can eventually find the rest of the documents. Would like to list them all at the same time.

Thx for helping, USNDW.