| WORKING WORLD
By Tamar Asedo Sherman
New York State and many others are considering the possibility of facing an Order of Selection federal ruling that requires its vocational rehabilitation departments to assist those individuals with the most significant disabilities first.
That is a requirement that must be met when a state cannot provide sufficient services to all who are eligible, either due to lack of staff or lack of financial or other resources. New York State—and presumably others as well—is on the brink, and many professionals and advocates alike want to avoid that situation.
It poses quite a dilemma. Do you help those who need it the most, who require the most time, effort and expense, and who realistically might never find employment in the current economy? Or do you help more people with less significant disabilities who might find employment with a lesser expenditure of time and resources, getting more results for your money?
A strong argument can be posed for either side. I am a member of the NY State Rehabilitation Council which guides and advises VESID (Vocational and Educational Services to Individuals with Disabilities), and we are struggling with this issue.
With a hiring freeze in effect throughout state government for more than two years now, there is a shortage of vocational rehabilitation counselors who can provide services to qualifying individuals with disabilities. Some counselors have a caseload of more than 200 individuals, resulting in long waiting periods in some district offices. At the same time, the state budget is being squeezed, further limiting the services that can be provided.
To be eligible for VESID services, an individual must have a physical, mental, emotional, or learning disability that interferes with their ability to work. There must also be a reasonable chance that the individual will become gainfully employed if he/she receives rehabilitation services.
In determining whether an applicant for vocational rehabilitation services is eligible, the presumption is that everyone can benefit from services regardless of severity of disability, that everyone can do some kind of work. That is a lofty ideal, but is it realistic, especially when millions of people without disabilities and with skills, education and experience are out of work?
If a VR counselor thinks an applicant cannot benefit from services, she must demonstrate “clear and convincing evidence” to that end. The individual might need to go through an assessment process and/or a trial work period with supports and services in order to show an inability to benefit. That process is time-consuming and expensive, as well.
The counselor must assign a level of disability when an applicant first applies for services based on the number and degree of functional limitations, the number of services required to reach an employment outcome, and the length of time those services might be needed. Categories are most significant, significant, and least significant. Services considered are those that are necessary “as a direct result of the disability” in order to “reduce the impact of limitations to the functional capacity.”
Limitations identify what an individual is unable to do as a result of the disability. They are measurable and present a substantial impediment to employment: mobility, communication, interpersonal skills, selfcare, self-direction, work skills and work tolerance.
Someone who uses a wheelchair has a significant limitation in terms of mobility, but might not be limited in other areas, depending on the level of spinal cord injury or progression of disease. The counselor must identify how these functional capacities relate to the individual’s unique employment factors: his strengths, priorities, abilities, interests, resources, concerns, capabilities and informed choice.
The relationship between functional limitations and functional capacities provides information to establish the individual’s vocational objectives, scope of services and the employment goal.
It’s not easy to make those determinations, and much is left to the discretion of the counselor, who must consider the intensity, frequency, and duration of the limitations in determining the extent of disability. The counselor also must explore the individual’s abilities, capabilities, and capacity to perform in work situations.
Some rehab professionals think that people with mild learning disabilities will be excluded from receiving job placement services; others think that people with substance abuse disorders will be dropped. Nevertheless, each case is taken on an individual basis.
I would rather see VESID serve more people with signifi cant disabilities than give intense services to fewer people with more signifi cant disabilities.
Which category would you help fi rst with limited resources? And how would you make that decision? Please let me know your opinion and I will report back in a subsequent column.
Tamar Asedo Sherman is an employment specialist. She can be reached at action@unitedspinal.org.
