Voc rehab CMs advocate for injured workers

Provide employees tools to make good decisions 

By Karen Provine, MS, CCM, CRC, LPC, CDMS
Commissioner, Commission for Case Manager Certification
Rolling Meadows, IL

When a person acquires a disability and can no longer perform the required tasks of his or her job, vocational rehabilitation is needed to help the individual return to work in another capacity. To facilitate this process, an analysis of transferable skills should be conducted up front. This early vocational intervention will help identify the necessary training and help empower individuals to make informed choices for themselves.

The role of the rehabilitation case manager or vocational professional is to advocate on behalf of the person by identifying the best ways to return to work. However, this can sometimes be a source of conflict, especially if the case manager or counselor and the individual hold different ideas about the best way to reenter the work force. Understanding the responsibilities and limits of the process can help rehabilitation case managers and other vocational professionals take a more proactive role to assist individuals with disabilities to become productive again.

According to the Council of State Administrators of Vocational Rehabilitation, 49 million Americans have a disability. Unemployment for Americans with disabilities is estimated to be as high as 70%, with 30% of these individuals indicating they want or are able to work. Rehabilitation case managers and vocational rehabilitation professionals have an opportunity to help these individuals with disabilities to enter or return to the work force.

Consider the case of George, who had an undergraduate degree in science and work experience including being a middle school teacher, a pharmaceutical compounder, and a construction worker. Past surgeries for knee injuries and repetitive stress injury in his right (dominant) hand, however, made him unable to perform the physical demands of his usual occupations, which required prolonged standing, reaching, and handling.

An analysis of his transferable skills revealed a wide array of knowledge and attributes, including: production and processing, rate control, operation monitoring, administration and management, reading comprehension, active listening, writing, speaking, learning strategies, instructing, synthesis/reorganization, implementation planning, operations analysis, time management, and attention to detail.

Training in job-seeking skills helped George identify and access sources of job leads, create a resume, answer interview questions, and manage his disability on the job. As a result, he was able to tap his network of contacts to identify, apply for, and obtain employment with benefits as a quality assurance analyst at a pharmaceutical company. The position allowed him to utilize his skills and education, while minimizing his limitations. George was very pleased with the outcome.

"I’ve worked all my life in physical labor jobs. It’s such a relief to be able to do desk duty. Thank you," he told his case manager.

As George’s case illustrates, the role of the vocational rehabilitation counselor and/or case manager is to assist the client in receiving maximum benefit from vocational services. This advocacy role, helping individuals to access the services they need in a timely and efficient manner, shows how the specific role of the rehabilitation case manager or vocational rehabilitation counselor relates to the broader field of case management.

Similarly, vocational rehabilitation professionals face challenges that are similar to those that case managers in general encounter. Our role is to provide individuals with the necessary tools to make informed choices and decisions regarding the services and options available to them. There are limits, however, to what we can provide. We cannot give someone carte blanche to pursue anything they wish; an injured production worker cannot decide to go to law school at someone else’s expense, for example. Nor can we sit idly by while clients set themselves up for failure.

Communication, info sharing are critical

When clients have unrealistic employment goals or expectations regarding the scope of services they are entitled to receive, communication and the sharing of information are critical. This often begins with an analysis of transferable skills, which to be most effective should be conducted up front. Traditionally, rehabilitation case managers and other vocational professionals have used resources such as the Classification of Jobs based on U.S. Department of Labor data to manually identify worker skills, which may be deployed in other jobs. Now, computerized methods and software (such as OASYS by VERTEK and a component of the Choices program by Careerware) have greatly facilitated the process.

Performing a skill analysis early on in the process helps individuals return to work more quickly, and typically at a higher wage than if they started a new career as an entry level employee. Other benefits of this early intervention include:

  • Gaps or interruptions in an individual’s work history are minimized.
  • Facilitating the return-to-work process may reduce extended disability payments and avoid provision of nonessential services.
  • Reliance on agencies is reduced and the likelihood of repeat applicants is decreased.
  • The job seeker is more in control of his or her own destiny and empowered to consider a range of alternatives. This allows the individual to make decisions and accept responsibility for results.

The case manager or vocational counselor must use tact and sensitivity when reviewing negative results of the skills analysis with the client to avoid damaging what may already be a fragile self-esteem. Clients who insist on formal retraining, but who do not appear to have the potential for success, may be supported on a semester-to-semester basis, with the understanding that if they are unable to meet the required academic standards, a direct placement plan will be developed and implemented.

One of the best options, providing a client with income and new skills, is on-the-job training. Many employers are receptive to this type of program. Helping a client obtain employment at a company that offers educational benefits or tuition reimbursement is another possibility. Case managers and vocational professionals also can help clients identify and obtain alternative sources of funding, such as financial aid, public assistance, or disability benefits, if appropriate, to help them pursue their goals independently.

When a person with a disability wants to return to work, the rehabilitation case manager or vocational professional can help identify resources and employment options. For this to be most effective, the analysis of transferable skills and training in independent job-seeking skills should be done early in the rehabilitation process. This puts the emphasis on the desired end goal: helping the individual pursue realistic and viable options to return to work.

[Editor’s note: Karen N. Provine, MS, CCM, CRC, LPC, CDMS, is a commissioner of the Commission for Case Manager Certification (CCMC), for which she also serves as secretary. The CCMC is the first certifying body for case management professionals to be accredited by the National Commission for Certifying Agencies. URAC also has determined that the CCM credential is a recognized case management certification. For more information or to obtain an application for the CCM, contact the CCMC at (847) 818-0292 or see the web site at www.ccmcertification.org.

Provine also is a vocational rehabilitation counselor with the New Mexico Division of Vocational Rehabilitation. Her responsibilities include coordinating vocational, medical and educational services for eligible persons with disabilities, providing placement assistance, and developing return-to-work programs.]