State Vocational Rehabilitation (VR) agencies submit Form SSA–199 to SSA to obtain reimbursement of costs incurred for providing VR services. SSA requires state VR agencies to submit reimbursement claims for the following categories: (1) Claiming reimbursement for VR services provided; (2) certifying adherence to cost containment policies and procedures; and (3) preparing causality statements. The respondents mail the paper copy of the SSA 199 to SSA for consideration and approval of the claim for reimbursement of cost incurred for SSA beneficiaries. For claims certifying adherence to cost containment policies and procedures, or for preparing causality statements, state VR agencies submit written requests as stipulated in SSA’s regulations within the Code of Federal Regulations. In most cases, SSA requires adherence to cost containment policies and procedures as well as causality statements prior to determining whether to reimburse the state VR agencies. SSA uses the information on the SSA-199, along with the written documentation, to determine whether or not, and how much, to pay the state VR agencies under SSA’s VR program. Respondents are state VR agencies who offer vocational and employment services to Social Security and Supplemental Security Income recipients. We are making a non-substantive change to re-add the formula cost worksheet to the Vocational Rehabilitation (VR) Provider Claim clearance package.
The latest form for Vocational Rehabilitation Provider Claim expires 2022-06-30 and can be found here.
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Form |
Supplementary Document |
Supporting Statement A |
Federal Enterprise Architecture: Income Security - General Retirement and Disability
Form SSA-199 | Vocational Rehabilitation Provider Claim | Fillable Printable | Form |
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