M28C.V.A.6 M28C.V.A.6 Case Closure

1. Case Manager

(Change Date November 7, 2013)

The case manager must make every effort to assist the claimant toward a rehabilitation outcome. However, when the claimant is unable or unwilling to continue receiving services toward that goal, the case manager is responsible for:

Reviewing all information in the claimant’s record.

Developing further information as needed.

Completing the case closure activities outlined below.

2. Veteran Readiness and Employment Officer

(Change Date July 16, 2021)

Except for cases being closed from Applicant (APP) or Evaluation and Planning (EP) statuses, the Veteran Readiness and Employment (VR&E) Officer must ensure that the:

Required procedures were followed.

Current information was used when justifying the closure.

Required criteria were met before a claimant’s case is closed.

b. Closure Activities

1. Interruption

(a) Movement to Interrupted Status

(Change Date November 7, 2013)

Title 38 of the Code of Federal Regulations (CFR) section 21.197 requires that a case be assigned to Interrupted status prior to placement in Discontinued status. The interruption is a temporary suspension of a claimant's program to determine if the claimant is able to resolve the situation that resulted to the interruption and resume his or her rehabilitation program.

(b) Exceptions to Movement to Interrupted Status

(Change Date February 28, 2021)

The following are instances that do not require interruption prior to a case closure:

• (1) Discontinuance of a case from APP status or EP status
• (2) The claimant requests closure of his or her case

2. Notification of Proposed Closure and Due Process Period

(a) Purpose

(Change Date November 16, 2018)

In accordance with 38 CFR 21.420, the purpose of a notification of proposed closure and due process is to provide the claimant a written notification, which indicates the reason(s) for the proposed closure, and to provide the required steps to continue receiving VR&E services.

The due process period provides the claimant with an opportunity to dispute the decision prior to the case closure. The due process period must be at least 30 days, but no more than 180 days, from the date on the notification letter of the proposed case closure.

(b) Required Notification Letters of Proposed Closures

(Change Date August 1, 2012)

The case manager must use one of the following Vocational Rehabilitation (VR) letters for notification of the proposed closure, as applicable:

• VR-47, Proposed Closure for Non-Pursuit of Claim
• VR-48, Proposed Discontinuance – Maximum Rehabilitation Gain (MRG)
• VR-49, Proposed Rehabilitation – Further Education
• VR-66, General Proposed Adverse Action

(c) Exceptions for Notification of Proposed Case Closure

(Change Date October 8, 2021)

A notification of a proposed case closure is not required in the following circumstances:

• (1) Rehabilitation for suitable employment after the claimant's successful completion of a rehabilitation plan
• (2) Rehabilitation for suitable employment obtained after the claimant's successful completion of services provided under 38 U.S.C. 3117
• (3) Rehabilitation based on the claimant's ability to maintain increased level of independent living skills after completing all or a major part of the IL plan

(4) The claimant requests to discontinue all actions on his or her Chapter 31 claim. Refer to section (d)(3) below for further actions.

(d) Actions after Notification of Proposed Closure

(Change Date May 17, 2023)

(1) The case manager may close the case if the claimant disagrees with case closure, such as when the claimant requested additional training, but the case manager determined that additional training is not necessary, and the claimant had already been informed of the adverse action for denial of additional training.

(2) The case manager may close the case if the claimant does not respond during the due process period. The case may be closed after 30 days but no later than 180 days from the date of the proposed adverse action letter. If the closure was not taken after 180 days, the claimant must be provided another proposed adverse action letter with a 30-day due process period.

(3) When a claimant requests to discontinue all actions on his or her Chapter 31 claim, and the case is in EE, RTE, JR, or INT status, the case manager may submit the case for concurrence of closure the same day.

In addition, the case manager must clearly document the claimant's verbal or written request in an electronic case note.

3. Closure Statement

(Change Date October 8, 2021)

The case manager must document and justify his or her decision to close the case via the completion of a closure statement. A closure statement is required for all cases being closed, except from Applicant (APP) status.

For closures from APP status, only a brief electronic case note about the reason for the closure is required.

For cases being closed from Evaluation and Planning (EP) status, at a minimum, a summary of what services were provided and what attempts were made to motivate the claimant to participate must be provided in a brief closure statement in the claimant's electronic record.

All closure statements for cases being closed from a plan of services must include the following, as applicable and documented in the claimant's electronic record.

Date of closure statement.

Current service-connected disability conditions and rating.

Employment handicap or serious employment handicap determination.

Remaining Chapter 31 entitlement.

Overview of the rehabilitation plan, to include the services provided and how the services impacted the claimant’s ability to overcome the vocational impairment.

Reason(s) for the decision to close the case.

Applicable regulatory guidelines that support the decision such as 38 CFR 21.283, and 38 CFR 21.364 for example.

Specific evidence supporting the decision.

Accurate reason code (RC), detailed reason code (DRC), if applicable that will be used to close the case, as well as an explanation for using the specified RC and DRC, if applicable.

Rehabilitation for suitable employment requires additional information on the closure statement, as noted below.

Type and description of degree or training completed

Beginning and ending dates for training

Cumulative grade point average

Beginning date of employment

Place of employment

Title of position

Supervisor’s name and contact information

Work requirements

Wage information

4. Third Party Information

(Change Date October 8, 2021)

Generally, the case manager must have direct contact with the claimant within 90 days prior to case closure. When the claimant fails to respond to the case manager, or loses contact, third party information may be used to attempt contact and validate the claimant’s status prior to case closure, provided such information is obtained no later than 120 days prior to case closure. When direct contact is established, the case manager must verify the accuracy of the information obtained from the third party and document it in the claimant’s VR&E record. The direct contact information must include the claimant’s current circumstances which substantiates the justification for the MRG closure. When it is not possible to establish direct contact, the claimant’s electronic folder should be clearly documented to show that efforts to establish contact were made by all available and appropriate methods. In these instances, when direct contact cannot be established, the case manager may use information from a third party to gain evidence necessary for a case closure. Examples of acceptable types of third-party information sources include, but are not limited to:

• Contract Counselor
• Disabled Veterans Outreach Program (DVOP) Specialist
• Local Veterans’ Employment Representative (LVER)
• School Certifying Official
• Veteran Service Office (VSO) Representative
• CAPRI Records

5. Required Supporting Documentation

(Change Date November 7, 2013)

The case manager must also ensure that the following supporting documents are included in the claimant’s VR&E record prior to obtaining concurrence for the case closure, as applicable:

A copy of the claimant’s diploma or certificate and transcript.

Declaration of the claimant’s job readiness.

Current rehabilitation plan.

Verification of employment assistance allowance (EAA) payments.

Completed VAF 28-0851, Activities for Daily Living Assessment at Case Closure.

6. Closure Forms

(Change Date October 16, 2024)

The case manager must complete the applicable closure form when requesting that a claimant’s case be closed. The VA forms (VAF) are dependent on the type of closure, as noted below:

• VAF 28-0850, Checklist for Proposed Rehabilitation
• VAF 28-0851, Activities for Daily Living Assessment at Case Closure
• VAF 28-0853, Checklist for Proposed Discontinuance

7. Veteran Readiness and Employment Officer Concurrence

(Change Date November 7, 2013)

The case manager must provide the information above to the VR&E Officer or designee to obtain concurrence prior to closing the claimant’s case.

If the VR&E Officer or designee does not concur with the proposed closure, he or she must explain the decision in an electronic case note for the case manager’s review. The case manager must perform one of the following tasks:

• Take the recommended action(s) to obtain concurrence to close the case, or

Consider alternative rehabilitation options if the recommended action(s) will not result in concurrence to close the case.

8. Final Closure Notification

(Change Date April 16, 2019)

Once concurrence to close the case is obtained, the case manager must inform the claimant of the closure. This final closure notification is completed via the use of the following VR letters:

• For rehabilitation and MRG closures - VR-64, Chapter 31 Positive Decision Letter
• For discontinuance, other than MRG closures - VR-58, Chapter 31 Adverse Decision Letter

9. CWINRS Update

(Change Date November 7, 2013)

The case manager must ensure that:

CWINRS reflects the accurate RC and DRC, if applicable, for the closure.

The effective date of a claimant’s closure in CWINRS is not earlier than the date of the VR&E Officer or designee concurred with the closure decision.

The closure date in CWINRS matches the date on the final closure notification letter.

The claimant’s employment data is correctly entered in CWINRS.

Please refer to the CWINRS User Guide for complete instructions on CWINRS closure activities and M28C.III.A.1 for required case status movements.

10. Contact the Veteran Service Center (VSC)

(Change Date November 16, 2017)

The case manager must review the claimant’s “Additional Rating Decisions” tab in Share to determine if the claimant is in receipt of Total Disability based on Individual Unemployability (TDIU). If so, the case manager must provide a copy of the claimant's closure letter to the VSC and must document in an electronic case note that notification was provided.

6.02 Closing a Claim as Rehabilitated

a. General Information

(Change Date August 1, 2012)

Refer to the M28C Glossary of Terms for definitions of related terms, including “rehabilitated” and “suitably employed,” per title 38 CFR 21.283.

b. Types of Rehabilitation Closures

1. Suitable Employment

(Change Date September 09, 2022)

A case manager may declare a claimant rehabilitated if the claimant has started and maintained suitable employment in the same occupation outlined in the Individualized Written Rehabilitation Plan (IWRP) and/or Individualized Employment Assistance Plan (IEAP) for at least 60 continuous days.

2. Temporary Employment

(Change Date March 31, 2014)

A case manager may declare a claimant who has been hired in a suitable, temporary position as rehabilitated if, after one year of employment, the claimant does not have additional vocational rehabilitation needs. Employment is considered temporary if the claimant is hired for a limited time period.

Refer to M28C.VI.A.2.08.d.3.(b) for period of employment services when temporary employment is converted to permanent status.

3. Term Employment

(Change Date March 31, 2014)

A case manager may declare a claimant who has been hired in a term position as rehabilitated if the claimant maintained suitable employment for at least 60 continuous days. Term employment may last one to four years and employee benefits may be provided.

4. Seasonal Employment

(Change Date August 1, 2012)

A case manager may declare a claimant who has been hired in a seasonal employment position as rehabilitated if the claimant maintained suitable employment for at least 60 continuous days. The case manager will consider seasonal employment, such as construction work, as permanent if it fits the pattern of the occupation.

5. Self-Employment

(Change Date October 16, 2024)

A claimant may be declared rehabilitated after he or she has successfully completed a plan of services for self-employment and satisfactorily participated in employment services for 12 months. The one-year employment services period begins after the VRC has determined that the claimant is job ready, the business is operational, and the claimant is successfully adjusted. The requirement for the extended employment services period is to ensure sustainability of the claimant’s business.

Refer to M28C.IV.C.5 for detailed information on self-employment.

6. Independent Living

(Change Date November 4, 2013)

The VRC or VRS may declare the claimant who has participated in an Individualized Independent Living Plan (IILP) rehabilitated when the claimant either has:

• Successfully completed all program goals, or
• Not successfully completed all program goals, but has:
• Achieved a substantial increase in the level of independence in daily living through VR&E assistance, and
• Maintained this level of independence for at least 60 continuous days, and

Further assistance is unlikely to significantly increase the claimant’s level of independence.

Refer to M28C.IV.C.6 for detailed information on IL services.

7. Volunteer Employment

(Change Date September 26, 2017)

Although volunteer employment may contribute to declaring a claimant rehabilitated, it cannot be the intended goal of a vocational rehabilitation program. The case manager may only consider non-pay employment as suitable employment under the following conditions:

• The claimant has received maximum services and assistance to obtain gainful suitable employment; and
• The case manager can justify the decision that non-pay employment is the maximum feasible attainment for the claimant; and
• The non-pay position is consistent with the claimant’s abilities, aptitudes, and interests; and
• The claimant has maintained the volunteer employment position for at least 60 continuous days

8. Claimant is Employable and Elects to Pursue Further Education

(Change Date August 1, 2012)

A case manager may declare a claimant rehabilitated if the claimant is employable and opts to pursue additional education or training instead of obtaining employment. However, the case manager must ensure the following criteria are met:

• The additional education or training that the claimant is pursuing has been considered and is not approved as part of his or her rehabilitation program; and
• The vocational goal that has been determined consistent with the claimant’s aptitudes, abilities, and interests, will be enhanced by the claimant’s completion of the additional education or training

9. Claimant Does Not Complete the Vocational Objectives on the Rehabilitation Plan

(Change Date August 1, 2012)

A case manager may declare a claimant rehabilitated even if the claimant has not completed the vocational objectives of the rehabilitation plan if the claimant has:

• Used the services provided by VR&E to obtain and maintain employment
• No further rehabilitation needs that can be addressed by VR&E, and
• Maintained employment consistent with the claimant’s interests, aptitudes, and abilities for the required duration

10. Claimant’s Employment is Closely Related to the Planned Goal

(Change Date February 12, 2021)

When a claimant obtains employment in a different vocational goal than the one identified on his or her rehabilitation plan, the case manager must make a determination that the employment is, or is not, closely related to the vocational goal outlined in the rehabilitation plan. To make this determination, the case manager must examine both the content of training and the level of training required for both occupations. A claimant must be able to use the training he or she has received from VR&E in the current employment before the current employment can be classified as closely related to the original vocational goal.

The Occupational Outlook Handbook (OOH) is generally the accepted source for occupational information and offers substantial assistance in making the determination for closely related occupations. The case manager must review the “Related Occupations” section in the OOH carefully as being listed as a related occupation does not necessarily mean that the employment will meet the definition of suitable employment since more than just training is used to make this determination. The related occupation must be within the claimant’s level of functional ability.

If the current employment is determined to be closely related to the vocational goal outlined in the rehabilitation plan, the plan does not need to be redeveloped and official advance notice of the rehabilitation is not necessary. However, the case manager must discuss this with the claimant and document the discussion in an electronic case note. The case note must indicate that the claimant is in agreement.

11. Claimant’s Employment is Unrelated to the Planned Goal

(Change Date July 2, 2014)

If the claimant obtains employment in an occupation unrelated to the vocational goal outlined on the rehabilitation plan, the case manager may make a rehabilitation determination. However, a new IEAP must be developed with the new occupational goal. The case manager must determine that the claimant has been employed for the required amount of time based on the type of employment and that:

• Intensive efforts to secure employment in the occupation outlined in the claimant’s original rehabilitation plan were provided
• The occupation is consistent with the claimant’s aptitudes, interests, and abilities, and

The occupation uses some of the academic, technical or professional knowledge and skills provided by VR&E.

12. Existing Business

(Change Date October 16, 2024)

A claimant, who did not participate in a self-employment plan of services initially, but opts to continue to work in his or her existing self-owned business, may be declared rehabilitated after 60 days of satisfactory participation in employment services, if all the following requirements are met:

(a) The claimant must have successfully participated in a plan of services for a suitable employment goal and has been declared job ready.

(b) The business must have been determined to be suitable.

(c) The existing business must have been successfully operational for at least 12 months as demonstrated by profit statements or tax returns.

c. Use of Social Media to Verify Employment

(Change Date October 8, 2021)

Many claimants will post information on social media platforms, including Facebook, Instagram, and LinkedIn. However, the information posted to these platforms is not always accurate. Therefore, precautions must be taken when using information posted to social media. If the case manager obtained the initial employment information, to include job title, salary, employer name/address, and start date, from the claimant directly or from a reliable third-party, as specified in M28C.VI.A.2.08.b , but the claimant does not respond during the 60-day follow-up period, detailed in M28C.VI.A.2.08.d , then using a social media source to verify continued employment may be appropriate. However, local VR&E staff must document in the VR&E record all efforts to contact the claimant. After these contact attempts are documented and the case manager identifies information on social media verifying that the claimant is still employed, the case manager must include the following information in the documentation about the social media post:

• Specific social media platform where the information was identified
• Date and time when the information was viewed
• Information contained in the post verifying that the claimant continues to be suitably employed

If the case manager is not able to initially obtain employment information directly from the claimant or from a reliable third-party, then merely seeing a social media post about his or her employment is not sufficient to rehabilitate the case. However, information contained in this post may be used in considering an MRG closure.

6.03 Closing a Claim as Discontinued

a. General Information

(Change Date November 7, 2013)

The term discontinued is defined as the termination of all VR&E services and benefits. In accordance with 38 CFR 21.198, the purpose of discontinued (DIS) status is to identify situations in which termination of all VR&E services and benefits is necessary.

Discontinuance is best utilized as a last resort. The case manager must exhaust all possible avenues to ensure the claimant’s needs are met prior to discontinuance, unless the claimant requests his or her case to be closed.

b. Types of Discontinued Closures

1. Eligibility and Entitlement

(Change Date November 7, 2013)

Unless the claimant desires employment assistance, the claimant’s case will be discontinued when:

• The claimant reaches the basic 12-year eligibility termination date and there is no basis for extension of entitlement; or

The claimant has used 48 months of entitlement under one or more Department of Veteran Affairs (VA) education programs identified in 38 U.S.C. 3695 and there is no basis for extension of entitlement.

2. Not Feasible and No IL Needs

(Change Date October 1, 2020)

If following participation in an Individualized Extended Evaluation Plan (IEEP), the outcome is a determination that the achievement of a vocational goal is not currently reasonably feasible and the claimant has no IL needs, the claimant’s case will be discontinued. VR&E Officer concurrence is required prior to closure.

3. Medical Issues

(Change Date November 7, 2013)

A claimant’s case will be discontinued when:

• The claimant is unable to participate in a rehabilitation program because of a serious physical or emotional problem for an extended period; and

VA medical staff is unable to estimate an approximate date by which the claimant will be able to begin or return to the program.

4. Claimant Elects Employment that is not Suitable

(Change Date July 2, 2014)

In situations where a claimant chooses to obtain and/or maintain unsuitable employment and does not wish to pursue further services that will lead to suitable employment, the case manager may discontinue services and assistance.

5. Other

(Change Date November 7, 2013)

(a) The claimant’s case will be placed in Discontinued status when the claimant does not meet the criteria for rehabilitation or MRG and:

Declines to initiate services after applying for Chapter 31 benefits.

His or her conduct or cooperation does not conform with the with the provisions of 38 CFR 21.362(c) as outlined in 38 CFR 21.364.

Fails to make progress in his or her rehabilitation program.

Requests to terminate all action on his or her claim.

Elects to pursue further education and is not employable.

Reports financial or family issues that cannot be resolved with additional VR&E services.

Has been recalled to active-duty status.

Dies and the date of his or her death has been verified. The date of death must be entered into Share prior to the case closure.

(b) The following are guidelines when a claimant agrees or requests closure of his or her case:

(1) When a claimant requests to terminate his or her Chapter 31 benefits, the case manager may place the claimant's case in Discontinued status the same day. This includes the instance in which a claimant was sent a notification of the proposed adverse action and he or she responds that he or she agrees with the case closure.

(2) The case manager must document the claimant's request or agreement in an electronic case note. The documentation must clearly show that efforts were made to encourage the claimant to continue with his or her rehabilitation program prior to closing the case.

(3) The VR&E Officer's concurrence must be obtained prior to the discontinuance of the case.

(4) The claimant must be informed of the adverse action using VR-58, Chapter 31 Adverse Action Decision Letter.

6.04 Closing a Claim Using Maximum Rehabilitation Gain

a. General Information

(Change Date August 12, 2022)

A Maximum Rehabilitation Gain (MRG) is defined as a comprehensive representation of the positive impact of the rehabilitation process. Assignment of a case in Discontinued status using an MRG is appropriate for a claimant who is unable or unwilling to complete his or her planned services but nevertheless has gained maximum benefits from the rehabilitation services and closure of his or her case will not meet the criteria for declaration of rehabilitation.

The determination to assign an MRG closure must be based on the claimant's current circumstances.

An MRG closure is not applicable for discontinuance for a case under an IWRP with a Deferred Vocational Goal since a suitable vocational goal has not been identified, as outlined in M28C.IV.C.4.

b. Types of MRG Closures

1. Maximum Rehabilitation Gain-1, RC 035

(Change Date July 1, 2015)

The use of MRG-1 is appropriate if all the following circumstances are present:

• The claimant is employed,
• VR&E services contributed to the claimant obtaining or maintaining current employment, and

The claimant does not meet the criteria for a rehabilitation as outlined in 38 CFR 21.283.

If the answer to each of the following questions is “Yes”, then the use of MRG-1 is appropriate:

• Is the claimant currently employed?
• Did the services provided by VR&E contribute to the claimant obtaining and maintaining the current employment?
• Does the current employment benefit the claimant, but does not meet the criteria for closure as “rehabilitated” in accordance with 38 CFR 21.283?

2. Maximum Rehabilitation Gain-2, RC 037

(Change Date June 18, 2020)

The use of MRG-2 is appropriate if the claimant:

• Completed all or some of the planned services leading toward a suitable vocational goal,
• Is currently employable in a suitable job, and

The services provided by VR&E enable the claimant to qualify for suitable employment.

MRG-2 includes instances where the claimant chooses to remain in the same unsuitable position that led to the finding of entitlement if the criteria above is met.

The type or duration of services provided by VR&E alone is not sufficient to justify the use of MRG-2. If the answer to each of the following questions is “Yes”, then the use of MRG-2 is appropriate:

• Have the claimant’s circumstances in the period following application for VR&E services improved?
• Did the services provided by VR&E contribute to the improvement in the claimant’s circumstance?
• Has the claimant overcome the impairments to employment noted during the initial evaluation?
• Is the claimant currently qualified and capable of obtaining employment in a suitable occupation?
• Did the services provided by VR&E contribute to the claimant’s employability?

c. Closure Statement

(Change Date November 7, 2013)

As outlined in section 6.01.b of this chapter, the closure statement must include certain elements; however, an MRG closure statement must also include the following information:

A description of the need for services that was based on the initial evaluation of the claimant’s impairment of employability.

Services that were actually provided, summarizing whether objectives were completed.

An explanation of whether the claimant is currently qualified for and capable of obtaining employment in a suitable occupation.

A synthesis of how the claimant meets the criteria for MRG-1 or MRG-2 and how specific VR&E services contributed to current circumstances to include the claimant’s employment, or employability in a suitable job, and how services improved the claimant’s circumstances.

Current information from the claimant must include the claimant’s current circumstances which are verified during direct contact that is established prior to closure of a case in Discontinued status using an MRG reason code. Current information is defined as information that justifies the MRG and is substantiated by direct contact with the claimant within 90 days prior to closure or, without direct contact (Third Party), is verified as accurate within 120 days prior to the date of closure.