1205.00 Alcoholism

(March 1992)

 

Table of Contents

Authority

Code of Federal Regualtions (CFR) 361.9; 361.19; 361.30-.42; 361.49.

Description

Alcoholism is a disease characterized by the loss of control over alcohol use and continued use despite persistent or recurrent physical, mental, legal, emotional, occupational or social problems. Alcoholism may also result in physical complications including hepatitis, cirrhosis, neurologic disorders, gastritis, heart disease, and reproductive disorders, among others.

Determination of Eligibility

Individuals will be referred to VESID by Division of Alcoholism and Alcohol Abuse (DAAA) certified alcoholism treatment clinics as well as by physicians, other agencies, family members and self referrals. Documentation of alcohol dependence or abuse must be made by a physician skilled in the diagnosis and treatment of mental or emotional disorders or by a licensed or certified psychologist. Evaluations from a DAAA certified treatment program can be used, if provided or countersigned by professionals meeting these criteria.

Documentation should contain information about the history, nature and extent of the disability, its development, and the impact of alcoholism on educational and vocational abilities to function at a suitable level. Referrals from DAAA certified treatment programs will be accompanied by a diagnosis, the treatment and/or discharge plan and available medical information. In many cases, this referral package will contain sufficient information to meet medical documentation needs.

Interim eligibility should be considered in situations where complete information is not initially provided and the VESID counselor has a strong indication that the individual meets the eligibility criteria. Services may be provided up to 90 calendar days under interim eligibility while necessary information is being collected.

Individuals in treatment must have made satisfactory progress toward achieving the goals of the established treatment plan which include abstinence from alcohol and any other mind-altering drugs not prescribed by a physician. When individuals are referred for VESID services, satisfactory progress will be based on the professional judgment of the primary counselor of the certified treatment program or by the referring physician or psychologist.

Persons with alcohol symptoms who apply for VESID services, but who do not have an alcohol diagnosis from a certified treatment program, a physician skilled in the diagnosis and treatment of mental or emotional disorders or a licensed or certified psychologist, should be referred to a DAAA certified outpatient program for an evaluation.

Persons do not have to be in a treatment program to receive VESID services. DAAA certified treatment programs or qualified physicians and psychologists can provide the VESID counselor with information concerning the need for treatment.

The following questions may provide information to help determine eligibility:

  1. Is the individual currently employed?
  2. Is this employment consistent with the individual's capacities?
  3. What kind of work history does the individual have?
  4. If the individual is unemployed, why is the individual unemployed (poor labor market, for example)?
  5. How does the individual's disability limit his/her employability?

For evaluation of illness or disability resulting from alcohol dependence, alcohol abuse or from other causes, a specialist in the organ system affected may need to be consulted. The specialist should be given all relevant clinical information and a statement that the individual has an alcohol diagnosis and has applied for vocational rehabilitation services. This information must be provided with an appropriate release of information.

A variety of work related limitations may result from alcoholism. The following issues should be considered when planning for services:

  1. Reduction of stress tolerance.
  2. Poor interpersonal relationships with co-workers or supervisors.
  3. Negative self-image.
  4. Fear of success, failure, or the unknown in the work setting.
  5. Employer prejudice due to poor work history.
  6. Possible criminal record.

Functional Criteria for Referrals

  1. All persons with disabilities related to alcoholism referred to VESID for services must meet the following standards in order to be eligible for VESID services:
    1. Stable housing or a plan to secure same;
    2. Absence or management of medical problems that would preclude participation in a vocational program; and
    3. Absence of legal issues that would preclude participation in a vocational program.
  2. Additionally, all persons referred to VESID who require treatment for alcoholism must meet the following standards:
     
    1. Responsible participation in treatment with satisfactory progress toward achievement of treatment goals; and
    2. Commitment to a discharge plan. VESID will have been informed in writing of the provisions of the plan before the individual is discharged.

The agreement between VESID and DAAA requires certified alcohol treatment programs to provide information on how an individual meets the functional criteria in II. A. and B. of this policy when referring treatment participants to VESID. The information accompanying a referral should assist in determining eligibility and, if the individual is found to be eligible, beginning service provision quickly.

Confidentiality

Information about the individual may not be released to or by VESID without written permission by the individual. The form that must be used is Form VES-22 or the appropriate release document from the treatment facility. Each consent form must have a duration no longer than that reasonable necessary, with a maximum of 180 days, to fulfill the purpose for which it is given. Any release must be limited to information necessary to fulfill the intent or purpose of the disclosure.

Another option available to District Offices is to develop a Qualified Service Organization Agreement (QSOA) between each DAAA treatment program and the VESID District Office. A signed QSOA allows the treatment program to disclose information to VESID on a need to know basis without signed releases from individuals.

Federal rules, including penalties of imprisonment, fine, or both, prohibit redisclosure of information unless expressly permitted by the written consent of the person to whom it pertains. A general authorization for the release of medical or other information is not sufficient for this purpose. Form VES-540, Prohibition on Redisclosure of Information Concerning Individuals with a Disability of Alcoholism or Substance Abuse, concerning redisclosure, must be attached to all disclosures of information concerning individuals with a disability of alcoholism or substance abuse.

Expand All | Collapse All
+ Current Provider Information
+ Vocational Rehabilitation
+ Policies Procedures