Preliminary Independent Living (IL) Assessment

Non-Substantive Change of VA Form 28-0791,

Preliminary Independent Living (IL) Assessment

(2900-0681)

VR&E Service requests the following changes be made to VA Form 28-0791, Preliminary Independent Living (IL) Assessment:

1 - The “IMPORTANT” and “READ TO VETERAN:  ACTIVITIES OF DAILY LIVING” paragraphs have been added to the top of page 1.  The assigned Vocational Rehabilitation Counselor (VRC) is to read the paragraph to a Veteran before asking the questions on the remainder of the form.  This change reduces the amount of paperwork a Veteran must complete individually.  The form was designed to initiate verbal interaction between the Veteran and the VRC regarding the Veteran’s activities of daily living and abilities to live independently.  This additional paragraph also reinforces with VRC(s) that the form is not to be handed to the Veteran for completion, except under very special circumstances which must be documented.

2 - In the paragraph under the title “PART I – ACTIVITIES OF DAILY LIVING”  the form stated, “Circle the number....” however, the form now has blocks and it should read, “Check the box....”

3 – The “PRIVACY ACT NOTICE” and “RESPONDENT BURDEN” paragraphs were moved from page 1 to page 4.

In the “PRIVACY ACT NOTICE,” the System of Records had omitted the number 28.  It read, “58VA21/22.”  It should read, “58VA21/22/28.”

 

The “RESPONDENT BURDEN” was relocated to the bottom of the form because a Veteran will rarely complete this form independently.  The relocation information is still available to the Veteran although it is located in a different place on the form.

4 – The “Column Score” and Total Score” for this Assessment were deleted.