Q & A on Employment of People with Physical Disabilities: Vocational Rehabilitation Services for Individuals with Physical Disabilities - April 2014
by Grant Revell, M.S., M.Ed. and Katherine Inge, Ph.D., O.T.R.
Individuals with physical disabilities may need support for finding and maintaining employment due to physical challenges and other barriers. Some of these supports may include but are not limited to guidance and counseling for selecting a career, job development, vocational training, on-the-job training, assistive technology devices and services, and personal assistance services. Knowing where to locate supports, including who can assist with funding, can be challenging to someone who is not familiar with the various agencies that provide employment services.
Vocational Rehabilitation (VR) is one option for obtaining the needed supports that lead to successful competitive employment outcomes. The Rehabilitation Act of 1973, as amended most recently in 1998 through Public Law 105-202, provides federal grants to states to operate comprehensive programs of vocational rehabilitation services for individuals with disabilities. Vocational Rehabilitation is a cooperative program between state and federal governments that exists in all 50 states, the District of Columbia, and the U.S. territories. Vocational Rehabilitation is the primary public program with a goal of supporting people with disabilities to achieve competitive employment outcomes.
This fact sheet will answer some of the frequently asked questions related to obtaining services from a state VR agency. First, a general overview of the Vocational Rehabilitation program is provided. Second, guidance on the effective access and use of the VR system by people with physical disabilities is presented.
Question: What potential services may be provided by a State Vocational Rehabilitation Agency?
Answer: State Vocational Rehabilitation agencies provide or arrange-for an array of services and supports focusing specifically on achievement of a competitive employment outcome. These services can include, but are not limited to, the following:
- Assessment for determining eligibility for VR services and for establishing an employment goal;
- Vocational counseling, guidance, and referral services;
- Physical restoration services;
- Vocational and other training, including on-the-job training;
- Augmentative and Alternative Communication devices;
- Personal assistance services, including training in the use of these services;
- Refitting of vans for people with mobility impairments;
- Assistive technology services and devices; and
- Job development and job placement services; and.
- Supported employment services including on-the-job training and support as provided by an employment specialist.
A state VR agency directly provides services such as counseling and guidance and job placement assistance. In addition, Vocational Rehabilitation agencies are well positioned to serve as the service coordination hub for employment oriented community services for eligible individuals with physical disabilities. A VR counselor working with an individual can arrange with other community providers to purchase services such as rehabilitation technology and supported employment. The ability of a VR agency to reach out into the community for individualized services is one of the key potential strengths of vocational rehabilitation.
Question: What is the process for receiving services from Vocational Rehabilitation?
Answer: The first step is determination of eligibility for VR services. Once an individual with a disability applies for services, eligibility usually must be determined within 60 days of application. Individuals who are receiving Supplemental Security Income (SSI) and/or Social Security Disability Insurance (SSDI) benefits have already been recognized as having a disability. Immediate eligibility may be granted to these applicants because of a presumption of eligibility based on the review process that has already taken place in determining eligibility for Social Security disability benefits.
Eligibility for VR services is determined by a VR counselor based on the following criteria: (1) the presence of a disability that is a substantial impediment to employment and (2) the expectation that provision of VR services will result in the individual achieving a competitive employment outcome. During the assessment phase of determining eligibility, a variety of vocational tests may be administered to determine if a person will benefit from VR services. If an individual has information that documents work history, training, education, or other information that demonstrates that he/she can benefit from VR services, this information can assist with eligibility determination. Once an individual is determined eligible for services, the next step is development of an Individualized Plan for Employment (IPE).
Question: What is an Individualized Plan for Employment?
Answer: The IPE is developed jointly by the VR counselor and the individual with a disability. The counselor and consumer relationship is the cornerstone of the rehabilitation system where both parties bring their knowledge, skills, and abilities to develop the IPE. The IPE identifies both the employment goal chosen by the individual and the services needed to achieve that goal. The IPE usually is most effective when it is developed in close cooperation with the individual’s family and primary support resources key to this person’s success in employment. These resources might include community agencies and programs such as Independent Living Centers and disability-specific support groups. The IPE identifies a number of key components of the plan for achieving an employment outcome. These components include but are not limited to the following:
- The employment goal chosen and agreed to by the individual with a disability including the desired number of hours of employment;
- The services identified by the counselor and the individual necessary to achieve the employment goal;
- The estimated cost, funding source, and timeline for each service;
- The identified provider, approved by the individual, for each identified service; and
- Timelines and indicators for measuring progress towards the goals identified in the IPE.
Vocational rehabilitation goals and services identified in the IPE can be amended with the agreement of the individual with a disability.
Question: What is the role of the VR counselor in the implementation of the IPE?
Answer: VR counselors provide a number of services directly, such as counseling and guidance as well as job placement assistance. VR counselors also provide case management and service coordination support. Case management through vocational rehabilitation continues until case closure occurs. Case closure can occur after a minimum of 90 days of employment in a job consistent with the employment goal established in the IPE. Case closure can also occur if the individual is not making progress towards achieving an employment outcome.
Vocational rehabilitation counselors have access to case service funds that can be used to purchase services identified in the IPE from approved service providers for financially eligible VR participants. Each VR agency establishes its financial eligibility policies, and these policies can differ among state VR agencies. VR funds can be used to purchase a variety of services. VR counselors are usually very familiar with other funding sources that can be used to complement VR funding. These are referred to as comparable resources. Deciding who will pay for services and supports can be part of the assistance provided to the individual with a physical disability by the VR counselor.
Question: What are examples of employment-related services, supports, and accommodations that are potentially available to individuals with physical disabilities?
Answer: There is an array of potential vocational rehabilitation services that might be of value to people with physical disabilities in achieving a successful employment outcome. These services can respond to a variety of support needs related to a physical disability including, for example, mobility and/or dexterity, communication, fatigue/muscular weakness, and/or the need for self-managing of personal care. Example potential services/accommodation can include but are not limited to the following:
- A scooter or other mobility aid;
- Vehicle or van modifications;
- Modifications to a workstation;
- Accessible office equipment such as voice activated speaker phone, large button phone, telephone headset, depending on the person’s support needs and preferences;
- Alternative access and input devices for computers such as speech recognition software, eye gaze systems, trackballs, key guards, and/or alternative keyboards, depending on the person’s support needs and preferences;
- Personal Assistance Services;
- Augmentative communication devices and other needed equipment to complete the essential functions of the person's job description.
Question: How is the decision made if VR funding will be used to pay for a specific service or support?
Answer: The strength of the VR program is its flexibility and its ability to respond to the allowance for provision of “other services as needed” in formulating an Individualized Plan for Employment. The challenge faced by the VR system is the need to be responsive to large number of people with disabilities seeking employment assistance with a limited amount of authorized funding. The answer to the question of what VR services are potentially available can vary substantially from person to person and is dependent on a number of individual factors that are identified in the IPE. These factors are:
- What is the individual’s employment goal, including the intermediate objectives set to measure progress towards achieving the employment goal?
- What are the specific services needed for the person to achieve the employment goal?
- What is the source and cost of each service?
- What are the varieties of comparable resources that can be used to acquire/fund each service?
Procedures and policies vary from state to state VR agencies. For example, policies regarding VR agency level of participation in the refitting of a vehicle/van for use by a person with a physical disability vary substantially across state VR programs. In approaching the question on what VR services are potentially available, it is important to recognize that there is not a definitive yes or no answer that can be provided for a particular service. The answers will vary to a degree from state to state. The first step in addressing the question is to respond to the four questions described above that are the basis for the IPE.
Question: Who pays for the Vocational Rehabilitation services identified in the Individualized Plan for Employment?
Answer: Funding for the services identified in the IPE are generally achieved through a blending of resources from various sources. Vocational Rehabilitation agencies can assist financially in a variety of ways in supporting an employment plan. VR financial support is frequently a part of a larger financial support plan. This support plan might include some amount of self financing by the person with a disability through, for example, available resources, loans (such as an Assistive Technology Loan fund), funds drawn from Social Security Work Incentives such as the Plans for Achieving Self Support (PASS), and grants/scholarships. Employers can be a potential resource in the areas of workplace accommodations. Depending on eligibility requirements for each source, funding can be provided by community partner agencies such as One Stop Career Centers through the Workforce Investment Program or services through the Medicaid Home and Community Based Waiver Services program.
As an example, VR may pay for assistive technology (AT) services or devices needed as an accommodation to achieve the individual's employment goal. Other comparable resources for obtaining an AT device may include the business where the individual will be employed or the individual with a physical disability using a Social Security work incentive such as an Impairment Related Work Expense (IRWE). Depending on the circumstances, the VR counselor may suggest that the individual ask the employer to purchase the device as an accommodation under the Americans with Disabilities Act (ADA). However, VR can waive the requirement of identifying and using comparable resources if doing so would delay the person's progress towards an employment goal. In this example, VR may pay for the AT device instead of the employer, but this is determined on a case by case basis. Each individual must work with his or her VR counselor on these decisions.
Question: Are there other things to consider when determining how a specific service or support will be funded?
Answer: Obviously there are many things to consider when determining how a support will be funded, including specific requirements of the funding source. For instance, VR can only pay for services as long as the individual is a VR client; however, the person may need the service in order to maintain employment. One example that can be used to illustrate this is the need for personal assistance services by an individual with a physical disability. Initially, VR may fund personal assistance services in the workplace to complete the essential functions of the identified job duties. Paying for the services may facilitate the business hiring the individual even though this could be a reasonable accommodation that the employer should pay for under the ADA. In other words, VR may pay for personal assistance services to speed the hiring process, but the employer will need to assume the cost as an on-going accommodation if the individual is to maintain employment.
Another example related to personal assistance services is the need for attendant care to prepare for work or for personal care needs in the workplace. In this example, the employer would not be responsible for funding personal care needs although some may voluntarily do so in the workplace. VR may pay on a time limited basis to facilitate employment but an alternative source of funding would need to be identified. In this example, the person with a physical disability may be able to use a Social Security work incentive such as an Impairment Related Work Expense (IRWE) to fund attendant care. VR paying for these services initially could facilitate employment rather than delay the process while waiting for approval of the work incentive by the Social Security Administration. As previously mentioned, deciding who will pay for services and supports can be part of the assistance provided to the individual with a physical disability by the VR counselor.
Question: What is the Client Assistance Program?
Answer: Although VR agencies work under federally mandated guidelines, there are variations from state to state in how VR eligibility guidelines are interpreted and applied. These variations in state-level VR policies and procedures can have a substantial impact on the extent to which VR services are available in a specific state and community Each state has a Client Assistance Program (frequently referred to as CAP) that is set up to provide information and protection and advocacy services for individuals with disabilities. Individuals with a disability and their families who have questions or concerns about the experience they have with a Vocational Rehabilitation Agency should consider utilizing the CAP in their state for information and assistance regarding the VR program. By law, each VR agency is required to have contact information available on the associated CAP for that state.
In summary, the Vocational Rehabilitation agency and counselor will be most supportive and responsive in assisting a person with a physical disability in achieving an employment goal when it is approached as a partner and as a resource. The VR counselor can help an individual explore the possibilities for employment, connect with a variety of resources within and outside of the VR agency that can be supportive, and potentially arrange for financial participation by the VR agency as a component of the employment plan. This support evolves from a sense of partnership.
In any initiative, partners need clear and confident information, commitment to an idea, a willingness to work aggressively towards accomplishing the idea, and at times, patience. Being a good partner with Vocational Rehabilitation will help tremendously in securing its assistance. Here are some suggestions for how an individual with a physical disability can maximize the effectiveness of Vocational Rehabilitation services and assistance in achieving a successful employment outcome:
- Become educated on VR Policies and Procedures: As noted a number of times in this Fact Sheet, policies and procedures governing VR services can vary considerably from state to state. These policies around financial participation by VR are particularly important. Many state Vocational Rehabilitation agencies have web sites that provide information on services and funding. Access and study this information; ask questions when needed. This information also is available through the vocational rehabilitation counselor.
- Utilize Personal Social Capital: The final key consideration is partnering with Vocational Rehabilitation is the importance of utilizing personal social capital available in the community to achieve an employment outcome. Social capital exists in many different forms through family, church, social contacts, vocational and a-vocational experiences and interests, and other links to the community. Each individual must capitalize on these social contacts and supports in formulating and achieving the employment goals identified in the Individual Plan for Employment.
The Job Accommodation Network (JAN) is the leading source of free, expert, and confidential guidance on workplace accommodations and disability employment issues. Working toward practical solutions that benefit both employer and employee, JAN helps people with disabilities enhance their employability, and shows employers how to capitalize on the value and talent that people with disabilities add to the workplace. Information about JAN can be obtained at: http://askjan.org/
The Job Accommodation Network maintains a national directory of CAP programs. This directory is available at the following link: http://askjan.org/cgi-win/TypeQuery.exe?039 Information for this FAQ fact sheet was developed for the VCU-RRTC on Employment of People with Physical Disabilities. The authors for this issue are Grant Revell, M.S., M.Ed. and Dr. Katherine Inge. Questions on this fact sheet should be directed to Grant Revell at [email@example.com] or (804) 828-6989. Questions on the VCU-RRTC or accommodations should be directed to Dr. Katherine Inge, Project Director at [firstname.lastname@example.org] or (804) 828-5956. For more information on the VCU-RRTC, please visit http://www.vcurrtc.org.
Virginia Commonwealth University, Rehabilitation Research and Training Center on Employment of People with Physical Disabilities (VCU-RRTC) is an equal opportunity/affirmative action institution providing access to education and employment without regard to age, race, color, national origin, gender, religion, sexual orientation, veteran's status, political affiliation, or disability. The VCU-RRTC is funded by the US Department of Education, National Institute on Disability, Independent Living, and Rehabilitation Research, grant #90RT503502.