RSA-227 for FY-2025: Submission #50

Provide some examples of some interesting cases during the past fiscal year. Case 1:

An adult woman diagnosed with OCD, Anxiety, and Scoliosis contacted MDLC after her Vocational Rehabilitation program refused to fund the education she needed to open and run the small business she had been building. The client had a background in personal training and pilates while receiving Vocational Rehabilitation support to continue her education in bodywork, with the goal of teaching lessons independently.
However, the client realized that learning Structural Integration, a bodywork method combining manual therapy, active client participation, breathwork, movement, and body-reading analysis over a series of sessions, would make her classes more sustainable, marketable, and beneficial for her own physical and mental health.
Education in this method would likely last about a year, but Vocational Rehabilitation refused to fund it, claiming it was neither necessary nor beneficial to the client’s employment goals. The client felt this was unfair, as the training was still related to bodywork, which it had previously supported financially.
MDLC’s attorney agreed to investigate, obtained a signed release, and reached out to the client’s VRS worker. The attorney also helped the client clarify her goals, including funding for vocational training, licensure, and long-term marketing assistance. After several unsuccessful attempts to reach the VR counselor, our attorney finally made contact and gathered the specific reasons for denial. There was no way to prove that Structural Integration training would make her business more competitive or meet her physical needs, as the client had not created a small-business plan or established a job goal including Structural Integration.
After learning this, our attorney determined an appeal would likely fail but provided the client with new options, including applying for small business development services. The attorney sent her an information sheet on the process and advised her to create a business plan and gather support from medical providers and physical therapists about the benefits of Structural Integration.
After several weeks, the client scheduled a new VRS meeting, and our attorney agreed to attend and advocate on her behalf. At the meeting, VRS requested additional medical documentation supporting the need for Structural Integration. Our attorney advised the client to contact her medical provider and discussed alternative options if VRS denied funding.
The client obtained documentation from her neurologist stating she could not run a business with personal training and Pilates alone and needed Structural Integration for success and her own health. Our attorney escalated the matter to the VRS Regional Manager and explained the situation, which led to involvement from the VRS policy specialist. Following these efforts, VRS agreed to fund the client’s training.
The client earned her certification and is now moving forward with launching her business. Thanks to MDLC’s attorney’s persistence and expertise in resolving complex administrative issues, the client is well on her way to vocational employment that she enjoys.

Case 2:

An adult woman living with a brain injury, chronic spinal complications, and post-traumatic stress disorder contacted MDLC after experiencing difficulties with her state Vocational Rehabilitation (VR) services after updating her employment plan. The client’s desire for a 245D Provider License that she would need to start her business was not written into her business plan. Instead, her plan was written for a Home Stabilization Service, which was incompatible with her long-term goals and the licensure she needed to properly bill DHS as an LLC. The client’s case managers seemed to be avoiding finding a resolution.
The client believed she was not receiving the level of support she needed from her assigned VR counselor and wanted to transfer to a different employment provider, have new discussions about her updated employment plan, and receive assistance exploring a potential PASS Plan (Plan to Achieve Self-Support) to save her income and resources to support her long-term vocational goals.
MDLC’s advocate reviewed the client’s employment plans, including her Individualized Plan for Employment (IPE) and her plan for Individual Placement and Support (IPS), to determine where her goals and services were not aligned. Our advocate then facilitated communication and set up meetings between themselves, the client, her new VR counselor, and her new business counselor assigned through the VR agency. After these meetings, the client’s team had a better idea of the client’s new plans and long-term goals and began working to meet her needs. Her team worked together with MDLC on her accommodations and how to remedy the issues with her current business plan. With this collaborative approach, the client was able to reconnect with her vocational team, clearly express her goals, and reestablish a sense of direction in her services.
As a result of MDLC’s involvement, the client finally felt heard and supported, noting that having an advocate by her side gave her the confidence to pursue her vocational goals. Since the client stated she was now on a clearer, more hopeful path toward employment that aligns with her strengths, needs, and long-term aspirations, MDLC’s advocate closed the case.

Case 3:

A woman with multiple disabilities, including significant hearing loss and a history of brain injuries and mental health issues, contacted MDLC’s CAP program for help accessing appropriate VR services and gaining employment. The client hoped to return to work in a school setting supporting students with disabilities as she had done previously, but her increasing hearing loss made it difficult to communicate with VR and county disability services staff. She had attempted several times to connect with the VR program in her area but felt discouraged after several negative interactions with regional leadership.
When CAP staff attempted to follow up with the client on these issues, it became clear that the client communicated best through video calls with captions enabled. After shifting to this accessible format, the client explained that she wanted to work with a VR counselor trained in Deaf and Hard of Hearing services. However, her request had not been granted because the counselor she would have preferred was assigned to a different region.
CAP staff advocated for the client to be reassigned to a counselor with appropriate training and communication skills. CAP staff explained to the region's VR staff that the client’s disability-related needs required access to a counselor who understood communication accommodations, had experience serving Deaf and Hard of Hearing applicants, and could provide VR services in an accessible manner.
VR ultimately agreed with CAP staff and assigned the client to a specialized counselor located outside her geographic region but within the statewide program. This counselor contacted the client to begin reestablishing services and developing an employment plan that aligned with her goals of helping students with disabilities.
Through CAP’s advocacy, the client regained access to VR services in a way that allowed her to thrive and removed barriers tied to previous negative experiences. Since the client had a renewed opportunity to pursue meaningful employment with support from a counselor she communicated well with, our attorney closed the case.

Case 4:

An adult woman with Spinal Muscular Atrophy contacted MDLC/CAP seeking help with maintaining independent living in an integrated community setting. Although she received services through the CADI waiver, she was not receiving adequate support or understanding from VR staff or her social worker. The client relied on a power wheelchair and several disability-related services, yet she lived in a gated apartment complex that severely limited her access to the surrounding community. She wished to relocate to a more integrated environment but felt overwhelmed by navigating disability services, waiver supports, and housing resources. The client had several degrees and at one point had an active teaching license, but she had not been able to renew it and return to work. Her VR counselor hadn’t given her any timelines or tools for reintegration, and the client felt like she was losing time she could have been using to improve her situation.
CAP staff coordinated a meeting that included the client, VR staff, and her county disability services case manager to address her concerns and identify concrete next steps for integration and returning to work. MDLC’s CAP attorney also provided the client with emergency housing resources and information about the Metropolitan Center for Independent Living (MCIL).
During the meeting, the client disclosed that she had recently received eviction papers for nonpayment of rent. Her rent far exceeded what she could afford on her disability benefits, and she had been unable to obtain assistance to resolve the issue. CAP staff immediately assisted her in completing an emergency housing intake with the local Legal Aid office and explained her rights within the eviction process.
VR staff expressed their willingness to remain involved and to resume vocational services once the client’s housing situation had stabilized. CAP staff ensured the client had the information and referrals she needed to work toward securing safe, affordable housing in the community. CAP staff also helped the client complete an intake with Southern Minnesota Regional Legal Services (SMRLS), advised her on seeking advocate representation at her upcoming eviction hearing, and provided guidance on properly following up with emergency housing resources.
Since VR staff had reengaged and were once again working with the client toward finding and retaining employment, and because CAP could not take further action regarding her housing, the case was closed. CAP staff made certain the client knew she could contact MDLC again if challenges arose with VR services once her housing had stabilized.
Through CAP’s intervention, the client received immediate support responding to her eviction, reestablished communication with VR, and strengthened her pathway toward integrated housing and future employment opportunities.