VIRGINIA COMMONWEALTH UNIVERSITY

NATIONAL RESOURCE CENTER
FOR TRAUMATIC BRAIN INJURY

Neuropsychology and Rehabilitation Psychology Division Department of Physical Medicine and Rehabilitation.

Vocational

QUESTION:
I lost my job after my injury because I could not keep up and produce at the level I used to. I do not think I can remain in this line of work, but I am not sure what types of jobs I should be applying for. I am not fully qualified for any alternative careers. Are there resources for helping me re-train and find appropriate employment in a new field?

ANSWER
Vocational rehabilitation is available throughout the United States for persons with physical, mental, and emotional disabilities. These services include vocational evaluation, guidance and counseling, vocational training, supported employment services, job placement services, technological aids and devices, and physical and mental restoration services. This comprehensive program of services is designed to help the individual determine skills and to find appropriate employment. In some states, the agency offering these services is called the "Vocational Rehabilitation" agency. In Virginia, the Department of Rehabilitative Services is the agency that offers this assistance to persons with disabilities. The administrative office is located in Richmond, with local branches serving Virginians statewide.

QUESTION:
When I apply for a job, am I required to tell the potential employer that I had a brain injury? Even if it is not required, should I disclose information about my injury? If so, when -- at the interview, when the job is offered, after employment is secured?

ANSWER
The Americans With Disabilities Act does not require applicants with disabilities to tell the potential employer. However, an employer is required only to make a reasonable accommodation to the known disability of the applicant. If the disability will require the employer to provide a reasonable accommodation, then it should be discussed, and the applicant should explain the type of accommodation needed and how it will impact job performance. If the disability is obvious and the employer has concerns as to how the applicant would perform the job functions, then the applicant should discuss how the functions will be performed. If the disability is not obvious and the applicant will not need accommodations, then it should not be discussed. If the disability is to be discussed at all, then the appropriate time would be during the interview. As long as the applicant is qualified for the job, but may need an accommodation to do the essential functions of the job, then it is better to discuss this with the employer initially.

QUESTION:
I returned to my job after surviving a head trauma which affected my memory and cognitive ability. I was able to perform my job, but it took me much longer to get things done. I never felt like my employer was on my side since the accident. I knew he would eventually fire me, instead of trying to help me accommodate my disabilities on the job. So I wasn’t surprised when recently I was let go for "inability to perform tasks necessary to the job." I feel that I was fired unjustly. Is this a case of discrimination? What are my options at this point?

ANSWER
Title I of the Americans With Disabilities Act prohibits discrimination under any conditions of employment for qualified persons with disabilities. It requires that employers base employment decisions on the person’s ability to perform the job, not on his or her disability or limitations. It also requires employers to provide reasonable accommodations when necessary to enable the qualified employee to perform the essential functions of the job. The employer is obligated to make reasonable accommodations unless it would impose an undue hardship. An employee who believes he or she has been discriminated against on the basis of disability can file a charge with the Equal Employment Opportunity Commission (EEOC). If there is no EEOC office nearby, call 1-800-669-4000.

QUESTION:

My son has been accepted into a special vocational program for people with severe brain injuries. Through the program he will receive vocational assessment, training, and placement services. The program uses a supported employment approach where a job coach will works along with the client in the training and placement phases. I am familiar with this approach for people with mental retardation, but I have not seen it used for people with brain injuries. What can I expect as far as the job coach’s responsibilities, my son’s chances for success, long-term support, etc?

ANSWER
Supported employment has proven to be a reliable option for assisting persons with severe disabilities, including traumatic brain injury, with going to work. What you can expect will be highly dependent upon the quality of services provided by the supported employment provider. Central to the concept of supported employment is the idea that the customer is in control of the process. The role of the employment specialist is to assist the customer in reaching his or her career goals. High quality supported employment service providers will incorporate these practices when implementing services.

Choice. The person would always have the opportunity to make choices concerning employment opportunities, such as type, hours, pay, etc.

Control. Control, refers to an individual’s ability to access supported employment services and to freely act upon his or her choices and decisions without fear of reprisal. Supported employment customers must also be free to participate in services. This might include choosing a service provider or employment specialist, accepting or declining a specific job, or electing to resign or continue employment with a particular company.

Careers. High quality service providers must be skilled in working closely with their customers to develop strategies for marketing their skills and abilities, establishing rapport with the business community, assessing employer needs, and conducting job analysis. Completing this process will yield an extensive amount of information for the customer to use when determining if the wages, benefits, and corporate culture are sufficient for long-term career development.

Full Community Inclusion. The customer works with the service provider to locate or create employment opportunities.

Long-Term Supports. Supported employment provides the necessary supports to assist an individual with long-term employment retention. By federal definition, supported employment includes at least two monthly contacts at the job site unless the customer requests otherwise. The long-term support component is an extremely unique feature among rehabilitation services.

Community & Business Supports. The direct service providers of supported employment should be spending less time actually engaged in delivering a support and more time engaged in assessing a situation with a customer, sharing information about possible support options, assisting the customer in accessing the support option, and evaluating the effectiveness of the strategy.

Continuous Quality Improvement. In a customer-driven approach to supported employment services, providers must listen to the wishes and desires of persons with significant disabilities to determine the agency’s mission, goals, and objectives. People with disabilities who are participating in supported employment or who are actively seeking services should be assisting in developing and evaluating services.

The employment specialist’s job functions are linked to major components of the support service to include the following: 1) customer profile; 2) career development; 3) employment match; 4) job site training and supports, and 5) long-term supports/extended services. However, the specific activities that the employment specialist actually performs within these categories will vary depending upon the needs of the individual requesting services.

Your son’s success will be highly dependent upon a number of factors such as the quality of supported employment services, the employment setting, and of course, your son’s ability to learn how to perform the job functions to meet the employer’s expectations. However, most importantly, it will be based upon the criteria you and your son choose to evaluate success.

Always keep in mind the saying, "If at first you do not succeed, try and try again!" A lot can be learned from a work experience which can be very useful when searching for future opportunities. It is critical for those involved to remain open-minded and learn from experience.

If your son receives supported employment funded by state vocational rehabilitation, then long-term support should be available. However, some states do not have funding for persons with traumatic brain injury; if this happens to be the case in your state, then your son will most likely be offered something called job coaching or time limited services. If funding is not available, you might investigate the possibility of writing a Plan for Achieving Self-Support, a Social Security work incentive to set aside funds to pay for the service. Another strategy would be to rally with other people who are interested in the welfare and services for survivors of brain injuries. Together, design strategies to advocate for money from your state general assembly (Virginia has done this) or consider setting aside monies from drunk driving restitution to pay for the needed service (Florida has done this). Finally, if funds are not available, encourage specialists to assist your son with finding a "buddy" at the work site that will give honest feedback on how things are going and can continue to do so after the employment specialist has faded.

QUESTION:
I received rehabilitation in the hospital for several weeks following a severe brain injury. It’s been a difficult road to "recovery," and I still have many serious impairments, including memory problems, paralysis, fatigue, and limited vision. None of my therapists addressed my returning to some type of employment, but I want to pursue this. Considering the severity of my disabilities, is this an unrealistic goal?

ANSWER
No, not at all. The secret will be to locate a work opportunity that compliments the use of your existing strengths and plays down any weaknesses. There are many types of accommodations that can enable you to perform the essential functions of a job. For example, to compensate for a poor short-term memory, you might consider writing down instructions and reading them back to the person who gave them or locating a job that is primarily routine. Fatigue might be compensated for by locating work that allows you to perform during the time of day when you are most alert, or you might investigate with a doctor whether or not there is medication available to alleviate this. If the fatigue would be directly related to the type of work activity, you might consider negotiating additional break times with the employer, and of course, you would want to give consideration to the nature of the work. Some jobs will require more strenuous activity than others. Also, take a look at environmental factors. Some people report feeling fatigued when working in a non-climate controlled environment.

Finally, you may want to consider hiring a supported employment program to work for you. Skilled professionals would be able to assist you with learning more about your strengths. Next, a job analysis, which provides useful information related to the types of accommodations that may enable you to perform particular job tasks, could be performed. Once employed, individual support is provided on the job. Contact your state Department of Vocational Rehabilitative Services to find out more about the supported employment service options in your area.

QUESTION:
My niece sustained a severe brain injury and is going through rehabilitation in the hospital right now. It looks like she will have permanent, serious disabilities, and I would like to help the family prepare for the future. One of my concerns is my niece’s ability to work again. What are the options for people with severe disabilities who may not be able to achieve competitive employment?

ANSWER
Unless your niece suffers from a serious unresolved medical problem, she should be able to find work in the community and be paid a competitive wage. You should learn more about supported employment, a vocational service option to assist persons with disabilities with going to work. Supported employment assists people with identifying their strengths and exploring the community to find an existing job or creating a job that utilizes those strengths.

At some point, you may hear about "workshops" or sheltered employment programs. In the past, facility-based programs offered families security, consistency, and safety. Today, this is not the only option. In fact, many people (service providers and customers alike) view sheltered employment as an unacceptable alternative. As your niece gets better and returns to the community it will most likely be very important to her to be accepted for who she is. She will be undergoing a lot of adjustments and probably will not want to be associated with people who have disabilities. Your niece must learn how she can put her existing strengths to use in a "real" work setting. I would highly recommend that you learn more about supported employment as a possible return-to-work service option for your niece.

1 comment (Add your own)

1. Rebeca wrote:
When Annie and I got married, it was our plan, if you will, that at some point I would rerite and SHE would then take up the burden of bringing home enough bacon to keep us going. I'm 14 years older than she, and we figured that that would work out nicely.Over time, and as her Ehlers Danlos became more and more of an issue in her day to day existence, working became more and more of an issue:Dress codes - because she needs to wear 'runners', and many places won't allow them.Comfortable chairs - many offices don't HAVE chairs available which are comfortable enough for her to spend 8 hours a day in.Flexible time: Because her condition often requires Doctor visits and other things that place demands on her time that conflict with a regular work schedule.Job concentration: Because remaining seated and in one place for long periods of time is, essentially, impossible for her - or at the very least, more difficult than it is for 'normal' people.And you're right. No one understands all of that. She 'looks' normal - except for those times when injury (which happens often) requires her to wear finger or wrist or foot and ankle braces.So she does not work. She gets a SMALL stipend from Social Security because she is 'Disabled'. if I die - she's fucked. Period.

Sat, March 14, 2015 @ 7:48 AM

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