From my understanding, yes, the VR&E rep is the gatekeeper. If you are currently in IDES (med boarding), then filling out and sending the VA 28-1900 form to the VR&E rep is just a formality; however is required to start the ball rolling. I then went through some virtual appointments to provide details on my education/training/interests, my medical conditions that prevent me from executing expected job duties in positions that I would currently be qualified for, and the accommodations I would need in order to obtain and maintain a position. I also had to take some career-type interest surveys and provide some job search data. The VR&E rep (basically a career counselor) works with you to identify viable positions/careers that will accommodate your medical issues; however they do try to utilize your previous/military education and training, if possible, so as to not start from scratch. So once, the VR&E rep and I agreed on a path forward, the rep found programs that would work with the VA (of course not all schools or training programs do). I am currently doing ecourses for data analytics and program management. Hope this helps!