- PHYSICAL
RESTORATION
"Physical restoration services" means those
services which are necessary to correct or substantially modify, within a
reasonable period of time, a physical condition which is stable or slowly
progressive. These services may include:
- Medical or corrective surgical treatment to correct
or substantially modify a physical condition which is stable or slowly
progressive and constitutes a substantial impediment to employment.
- Hospitalization (either inpatient or
outpatient care) in connection with surgery or treatment and clinic
services.
- Dentistry
- Drugs and supplies
- Prosthetic, orthotic, or other assistive devices
essential to obtaining or retaining employment
- Eyeglasses and visual services
- Podiatry
- Physical Therapy, Occupational Therapy, speech and
hearing services
- Chiropractic
- Medical or medically related social work services
- Treatment of either acute or chronic medical
complications and emergencies which are associated with or arise out of
the provision of rehabilitation services; or are inherent in the condition
under treatment.
- Special services for treatment of consumers suffering
from end stage renal disease, including transplants, dialysis, artificial
kidneys, and supplies.
General Considerations:
1. Physical restoration services are subject to
financial needs testing.
2. All comparable benefits must be considered
prior to providing physical restoration services.
3. The Department will not pay for sex change
operations.
4. Transplants or implant procedures which are
experimental or which do not have a consistent record of significant
improvement in vocational functioning in better than 50% of the subjects
shall not be provided by the Department.
Physical services may be authorized to out-of-state
vendors under the following circumstances:
- In geographical areas routinely used for the
convenience of the consumer; or
- When it will be economically beneficial to
the Department; or
- If a particular procedure or mode of treatment is not
available in state. The schedule of payment shall be governed by the rates
established by the vocational rehabilitation agency in the state where
services are to be provided.
The Central Office Program Administrator in charge of
fee schedules must be contacted concerning provision of out of state services.
- Medical
Consultation
The Department has access to a medical consultant
whose services may be used in the following manner:
- The medical consultant may review medical data to
determine the existence of disability as it relates to determination of
eligibility.
- The medical consultant may be used to assist the
Department in determining an acceptable fee for medical services not
clearly delineated in the established fee schedule.
- The medical consultant may be used to determine the
medical prognosis of clients with progressive conditions that may affect
the outcome of the rehabilitation program.
4. The medical consultant may assist the
counselors in interpreting medical information and in assessing
impediments to employment.
To request medical consultation, contact the Field
Administrator.
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