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VBA VA Form 28-1902w, known as “Rehabilitation Needs Inventory,” is utilized by the Veterans Benefits Administration (VBA) as part of the U.S. Department of Veterans Affairs. This form is specifically designed to aid in the evaluation process of veterans who are entering the Vocational Rehabilitation and Employment (VR&E) program. It serves to assess the vocational needs and rehabilitation potential of veterans, ensuring they receive tailored support and services that align with their individual rehabilitation goals and employment needs.
The form functions as a detailed questionnaire that gathers information about a veteran’s current employment status, educational background, and vocational aspirations. It also inquires about barriers to employment, such as physical or mental health challenges, which might affect the veteran’s ability to work.
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What it is: This form is used during the comprehensive initial evaluation to assist with gathering information for an Entitlement Determination.
Who signs: Enter the name of vocational rehabilitation counselor in 29. And the DATE (MM/DD/YYYY) in 30.
During the initial evaluation, the Vocational Rehabilitation Counselor (VRC) will review the form with the claimant to obtain additional and/or missing information necessary to determine the claimant's entitlement to Chapter 31 benefits.
Enter the CLAIMANT'S NAME (First, Middle Initial, Last).
Enter the VA FILE NUMBER (Last four) and the VRC NAME.
Please verify the claimant's contact information. If the claimant's contact information has changed or is different, please advise the claimant to update their contact information and/or marital status on VA.gov profile.
Mark verified claimant's address, verified claimant's email address, verified claimant's marital status and verified claimant's phone number.
If the claimant provides their resume, it is not necessary to duplicate information in Items 1-9. However, the civilian employment (including self-employment) history must be reviewed and discussed to identify any difficulties with job duties, obtaining and maintaining employment, salary, full time, part-time, and reasons why claimant left job positions.
Mark claimant provided resume (Please complete fields not on resume) or claimant did not provide resume (Please complete the section).
1. Is the claimant currently employed including self employment? If "Yes," go to #4. If "No," go to #2.
2. If the claimant is unemployed, enter how long the claimant has been unemployed.
3. Enter what the claimant did during the period of unemployment.
For 4., 5., 6., 7. And 8., enter the job title, name of employer, dates of employment, full-time or part-time, average gross monthly salary and a description of job duties in detail.
Do the job duties aggravate the claimant's service-connected disabilities? If "Yes," how?
Enter the claimant's reason for leaving employment (e.g. Resigned, fired, hired for another job).
9. Has the claimant ever had difficulty with any of the following item(s) due to their SCD(s)? If "Yes," please describe in detail.
For each of co-worker relations, job performance, job opportunities, job satisfaction, manager relations, missed time at work and OTHERS, mark the box if the claimant has had difficulty with it due to their SCD(s).
If the claimant provides their DD-214 or military records, it is not necessary to duplicate information in Items 10-13. However, the military employment history must be discussed to identify any difficulties with job duties, obtaining and maintaining employment, salary, full time, part-time, and reasons why claimant is unable to perform the job positions.
Mark CLAIMANT PROVIDED DD-214 or military records (Please complete only fields not on DD-214 or military records) or claimant did not provide DD-214 or military records (Please complete section).
10. List the claimant's military enlistment history. 11. Enter the job title or military occupational specialty.
12A. Mark the name of branch of service: Army, navy, air force, marine corps, coast guard, space force, NOAA, USPHS, SELECTED SERVICE or OTHER (Specify). SELECTED SERVICE (Note: Members or former members of the Selected Reserve (Army, Air Force, Coast Guard, Marine Corps, Naval Reserve, Air National Guard, or Army National Guard) who served at least one enlistment or, in the case of an officer, the period of initial obligation, or were discharged for disability incurred or aggravated in line of duty.) Enter 12B dates of service and 12C RANK.
13A. Mark the name of branch of service if the claimant served more than one term of service and/or more than one branch of service. Enter 13B dates of service and 13C RANK.
14. If the claimant has a history of or is currently dealing with legal issues, select item(s) that apply and describe: BANKRUPTCY (In the last seven years), misdemeanor, felony, probation, parole, other or NOT APPLICABLE.
15. If the claimant has a history of or is currently dealing with substance abuse issues, select item(s) that apply and describe: Alcohol, illegal drugs, prescription drugs, other or NOT APPLICABLE.
If the claimant had a history of or is currently receiving ongoing treatment(s) for substance abuse, describe treatment progress including date(s) and location(s).
If the claimant provided academic or training transcripts, certifications and/or licenses, please review their educational and/or training history. Mark claimant provided transcripts, certifications, and/or licenses (Do not need to complete all fields in this section.) or claimant did not provide transcripts/certifications, and/or licenses (Please complete section).
16. Mark the highest level of education the claimant has completed: Some high school, high school, general educational development (GED) certificate, associate's degree, bachelor's degree, master's degree or POSTGRADUATE DEGREE.
17. If claimant has education beyond high school, enter the field of study (Degree Major), if applicable. 18. If claimant has certification(s) or licenses (e.g. Apprenticeship, Journeyman License, Commercial Driver's License (CDL)), please list if applicable.
Discuss how the claimant's disabilities impact their ability to obtain and maintain employment. 19. List the claimant's service-connected disabilities and impairments.
20. Has the claimant filed a claim or is claimant receiving individual unemployability (IU) or total disability based on individual unemployability (TDIU)? If "Yes," discuss in detail. VRC must review for the severity of claimant's SCDs, feasibility, and potential independent living needs.
21. Does the claimant have a valid driver"s license? If "No," please explain reason for not having a valid driver's license. 22. Enter the name of medical treatment facilities the claimant is attending. 23. Enter how often the claimant is seen for treatment.
While the following information is not relevant to the entitlement determination, these questions can assist with referrals, resources, and addressing claimant's needs.
24. Is claimant registered with a local VA MEDICAL CENTER? Mark YES or NO.
25. Is claimant registered with myhealthevet? Mark YES or NO.
26. Does the claimant require a referral for hudvash or a homeless program? Mark YES or NO.
27. Check item(s) that apply if claimant is receiving or has applied for benefits: Disability pension (not disability compensation), retirement, medicare/medicaid, social security disability income (SSDI OR SSI), workers compensation, program of vocational rehabilitation or OTHER.
28. Enter other relevant information or additional comments (Additional information provided during the initial evaluation that is relevant to the entitlement determination).
Enter the name of vocational rehabilitation counselor in 29. And the DATE (MM/DD/YYYY) in 30.
[1] VA Form 28-1902w (NOV 2024), Information for Veteran Readiness and Employment Entitlement Determination, Department of Veterans Affairs (the Official source link on this page).