payments are being paid routinely and regularly. These expenses may be counted only as they relate to the primary and/or secondary impairment(s) used to establish eligibility. G. Client certification: The individual or, as appropriate, his/her parent or guardian, must sign and date the form in the appropriate place certifying the truth of the information which appears at the top portion of the form. H. Certification of financial need: The Certified Rehabilitation Counselor must certify on the form the individual whose name appears as a part of the certification is within the established limit for the provision of paid vocational rehabilitation services. A copy shall be given to the client. 206.1.08 Individual circumstances may occur wherein rigid adherence to the financial needs policy detailed above would seriously jeopardize an individual’s opportunity to achieve appropriate rehabilitation objectives. In such instance the counselor, in consultation with the Team Lead, may elect to seek an exception to the applicable policy. 206.1.09 If an individual fails to meet the financial need criteria for the Vocational Rehabilitation Program to purchase all planned services, the counselor shall then determine the appropriate level of the client’s participation in the cost of services. The Certified Rehabilitation Counselor should encourage the individual to utilize his/her personal assets to purchase certain needed vocational rehabilitation services as indicated in the IPE. VR shall not accept liability for a client’s financial responsibility. 206.2.00 INFORMATION: 206.2.01 Income includes money, wages and salaries before any deductions; net receipts from non-farm/self-employment (receipts from a person’s own unincorporated business, professional enterprise, or partnership, after deductions for business expenses); net receipts from farm (receipts from a farm which one operates as an owner, renter, or sharecropper, after deductions for farm operating expenses); regular payments from Social Security, IRA(s), railroad retirement, self-
208.1.07 The following impairments require documentation from the following specialists for determination of eligibility to be based on the specified impairment: AIDS: 1. Internist; certified and skilled in infectious diseases or immunology; 2. Specialist in family practice; 3. Other physician skilled in the diagnosis of HIV. 4. Advanced Practice Registered Nurse or Physician Assistant working in a public health setting and skilled in the diagnosis of HIV (Refer to Glossary: Public Health Setting) Alcohol or drug dependency: Physician (MD or DO) Psychologist; Psychiatrist; Advanced Practice Registered Nurse or Physician Assistant working in a public health setting and skilled in the diagnosis of alcohol or drug dependency (Refer to Glossary: Public Health Setting) Licensed Clinical Social Worker 6. Licensed Professional Counselor Amputation: Certified Rehabilitation Counselor observation; Internist or specialist in the field of circulatory problems if diabetes is suspected. Arthritis:
Assistive work technology occupations include: Rehabilitation engineer; (software, electrical, etc.) Rehabilitation technologist; Fabricator; Occupational therapist; Physical therapist; Speech pathologist; Special education teacher; Orthotist and Prosthetist; Physiatrist; Rehabilitation Technician. 458.0.00 CHILD CARE Effective Date: October 1, 1999 458.1.00 POLICY: 458.1.01 VR may authorize child care for children twelve years old and younger only to enable an individual with a disability to participate in a primary vocational rehabilitation service. 458.1.02 VR may authorize childcare only for those hours, plus two, that the individual with a disability is actively participating in a primary vocational rehabilitation service. 458.1.03 VR may not authorize childcare to enable an individual with a disability to participate in another service overnight or to otherwise be away from home for prolonged periods of time.
610.1.03 Information used to document the impairment shall be obtained from a specialist in the field or other appropriate source and such information shall reflect the current level of functioning of the individual. 610.2.00 INFORMATION: 610.2.01 There are two general categories of cardiac disorder, congenital and acquired. 610.2.02 Cardiovascular disorders include but are not limited to the following: Chronic heart failure; Hypertensive cardiovascular disease; Ischemic heart disease; Recurrent arrhythmias; Symptomatic congenital heart disease; Valvular heart disease or other stenotic defects or valvular regurgitation; Cardiomyopathies; Cardiac transplantation; Aneurysm of aorta or major branches (due to any cause); Peripheral arterial disease. 610.2.03 Cardiovascular impairment results from one or more of four consequences of heart disease: Chronic heart failure or ventricular dysfunction; Discomfort or pain due to myocardial ischemia, with or without necrosis of heart muscle;
Syncope, or near syncope, due to inadequate cerebral perfusion from any cardiac cause such as obstruction of flow or disturbance in rhythm or conduction resulting in inadequate cardiac output; and/or Central cyanosis due to right-to-left shunt, arterial de-saturation, or pulmonary vascular disease. 610.2.04 Impairment from diseases of arteries and veins may result from disorders of the vasculature in the central nervous system, eyes, kidney, and other organs. 610.2.05 Primary (or “essential”) hypertension, in which there is no related damage, would not generally produce functional limitations that would constitute an impediment to employment. 612.0.00 DIGESTIVE SYSTEM Effective Date: October 1, 1999 612.1.00 POLICY: 612.1.01 VR may authorize or provide services for a client with a digestive system impairment. 612.1.02 Information used to document the impairment shall be obtained from a specialist in the field or other appropriate source and such information shall reflect the current level of functioning of the individual. 612.2.00 INFORMATION: 612.2.01 Digestive system disorders include but are not limited to: Peptic ulcer disease (where the ulcer condition is not acute or of an emergency nature); Chronic liver disease (e.g. portal, post-necrotic, or biliary cirrhosis; chronic active hepatitis; or Wilson’s disease); Stricture, stenosis or obstruction of the esophagus; Chronic ulcerative or granulomatous colitis;