Independent Living Rehabilitation Policy Manual

ILR – Chapter 1



DESIGNATED STATE UNIT – Rehabilitation Services for the Blind (RSB) is the designated state unit that is referred to in 34 CFR 364.4.

STATE UNIT DIRECTOR – The Deputy Director, Family Support Division, Rehabilitation Services for the Blind, is the state unit director.

APPLICANT – An applicant is any individual who has applied for Independent Living Rehabilitation (ILR) services and whose eligibility for services has not been determined.

CLIENT – A client is an individual with a significant disability as defined by IL regulations and who meets RSB criteria to receive services.

LEGAL BLINDNESS – Legal blindness means a central visual acuity of 20/200 or less in the better eye with corrective lenses, or central acuity of more than 20/200 if there is a field defect such that the peripheral diameter of central visual field subtends an angular distance no greater than 20 degrees.

SOLE STATE AGENCY – The Family Support Division is the sole state agency referred to in 34 CFR 364.4.


  1. That an individual is legally blind, or
  2. That an individual with a progressive impairment of the visual systems has a central visual acuity of 20/70 or worse in the better eye with best correction, or has near vision that is decreased to the extent that the individual cannot read print that is smaller than Jaeger nine (J9) with best correction, or
  3. That an individual with a non‑progressive impairment of the visual systems has a visual efficiency (visual acuity and visual field) that does not exceed twenty percent (20%), or
  4.  That an individual with a progressive impairment of the visual systems has a visual efficiency (visual acuity and visual field) that does not exceed sixty four percent (64%), or
  5. Visual Efficiency Resources :
      1. Computation of Visual Acuity
      2. Computation of Visual Field Percentage
      3. Visual Efficiency Worksheet
      4. Instructions for Determining Visual Efficiency 
      5. Use of the SSA test Kinetic
  6. When, due to age or severity of the disability, the examiner is unable to obtain visual acuities for inclusion with the required eye reports, the staff member can consider the individual eligible for services based on the functional limitations caused by the visual condition if the functional limitations are consistent with the best corrected acuities/fields expressed in 1:5 above.



Rehabilitation Services for the Blind staff will contact all referrals within 45 calendar days and determine eligibility within 60 calendar days.


As appropriate to individual need, clients will be referred to other programs or agencies throughout the rehabilitation process.


00 – Referral

02 – Applicant

08 – Closed from applicant status

10 – ILP development

18 – Training/Service status

26 – Closed, Rehabilitated

28- Closed, Not Rehabilitated Following Services

30 – Closed, Not Rehabilitated Before Services


The Missouri Family Support Division, Rehabilitation Services for the Blind, assures that eligibility requirements are applied without regard to sex, race, age, creed, color, disability or national origin of the individual applying for services. No individual will be excluded or found ineligible solely on the basis of type of disability. No upper or lower age limit will be established which will, in and of itself, result in a finding of ineligibility.


The staff member shall maintain a case record for each applicant/client that will contain pertinent documentation of the following factors, as appropriate:

NOTE: Click on the following link for guidance on Good Practices in Case Narration

  1. An application requesting ILR services;
  2. Documentation supporting the staff member’s determination of visual eligibility or ineligibility;
  3. The services requested by applicant/client;
  4. Either the Independent Living Plan (ILP) developed with the client or a waiver signed by the client stating that an ILP is not necessary, along with all required information detailed in Chapter 3 (Independent Living Plan);
  5. Completed Health Assessment Questionnaire or adequate medical documentation;
  6. Evidence that all available resources have been exhausted prior to authorization of diabetic evaluation and/or education services;
  7. The services provided to the client, justification for purchasing equipment and/or services related to rehabilitation needs, including non-vision related needs (authorizations for non-vision related services or products, i.e., adapted blood pressure monitors, scales, must include justification from an appropriate health care professional).
  8. Documentation indicating whether the client’s goals/objectives were achieved.
  9. Evidence the client was a copy of notification of privacy practices regarding protected health information.


The staff member will provide to the client information regarding the Client Assistance Program (CAP) whenever a substantive change occurs in the case following application (i.e., eligibility/ineligibility determination, closure, etc.)


The Deputy Director, or his or her designee, shall have the sole responsibility for any exceptions to this policy manual.


The policies in this manual are written in accordance with 34 CFR 364 and 365.


Materials and/or communication will be provided in accessible format and/or languages.


Rehabilitation Services for the Blind’s Independent Living Rehabilitation program, through its policies and procedures, will comply with federal provisions of the Health Insurance Portability and Accountability Act as it relates to the protection, use and release of health information. See Appendix A for HIPAA information.