PRINCIPLES OF VOCATIONAL

REHABILITATION
PRESENTER: SNEHA MANDAR
• Introduction
• Background
• Goals
• Objectives
• Models
• Principles
• Process
• VR Centers
• Case study
• Schemes
• Summary
DISABILITY

 The International Classification of Functioning, Disability and Health (ICF),

published in 2001, defines disability as an umbrella term for impairments,
activity limitations and participation restrictions.

 Disability refers to “the outcome or result of a complex relationship between

an individual’s health condition and personal factors, and of the external
factors that represent the circumstances in which the individual lives”
 Disability is meant to focus on the individual, societal, and body-related
aspects of impairments, activity limitations, and participation restrictions in
the environment.
WHO, 2001

4
Disability in India
6
 • Overall percentage of persons with disability in
the population was 2.2 percent during July 2018
to December 2018 in the country, showed a
National Statistical Office (NSO) survey report
on Saturday.

PREVALANCE • The NSO, a wing of the Ministry of Statistics

and Programmed Implementation, has
conducted a Survey of Persons with Disabilities
during July 2018 to December 2018 as a part of
76th round of National Sample Survey (NSS).

Economic Times 2018

• In India, prevalence of disability (percentage of persons with disability in
the population) was 2.2 percent - with 2.3 per cent in rural and 2 per cent in
urban areas

• Prevalence of disability was higher among males than females

• Among males, prevalence of disability was 2.4 percent, while it was 1.9 per
cent among females
Economic Times, 2018
 Person with Disability

• Person with disabilities have long term physical, mental, intellectual or sensory
impairments which in interaction within various barriers hinder their full and effective
expectations in society on an equal basis with others.
UN 2006

• One who usually considered to be different from a normal person physically

physiologically, neurologically or psychologically because of accidents, disease, birth
defect or developmental problem
Herr and Cramer, 1996
• A person with disabilities means a person suffering from not less than 40% of any
disability as certified by a medical authority
Blindness
Low vision
Leprosy
Hearing impairment
Locomotor disability
Mental retardation
Mental illness
Physical disability
Learning disability
According to WHO
• According to VR, an individual with a significant disability is someone who:
1. has a physical or mental impairment that seriously limits one or more
functional capacities (such as mobility, communication, self-care, self-
direction, interpersonal skills, work tolerance, or work skills) in terms of an
employment outcome
2. can be expected to require multiple VR services over an extended period of
time
3. has one or more physical or mental disabilities resulting from amputation,
arthritis, autism, blindness, burn injury, cancer, cerebral palsy, etc.
• Individuals are classified as having:
No significant disability
Significant disability, or
Most significant disability

• A person with a “most significant disability” meets the above criteria and has
additional functional limitations as defined by the VR agency.
 INTRODUCTION
• VR is a complex component

• VR plays an important role in people’s lives when it comes to

returning to work following a period of illness or injury. There is,
however, no standard definition of VR.

• VR forms a significant part of the efforts and measures undertaken

to help people with a work disability to RTW
DEFINITION
• VR ‘Medical, psychological, social and occupational activities aiming to re-
establish among sick or injured people with previous work history their
working capacity and prerequisites for returning to the labor market, i.e., to a
job or availability for a job’.

• VR should be: ‘Medical, psychological, social and occupational activities

aiming to re-establish among sick or injured people their working capacity and
prerequisites for returning or entering the labor market, i.e., to a job or
availability for a job’.
• The ICF is a conceptual framework
and classification system by the WHO
to provide a language and framework
for the description of health and
health-related states that can be used
consistently across different countries
and settings.

• The ICF seeks to encompass what a

person does or can do, covering not
just physical functions and structures
but also activities and participation
together with environmental and other
contextual factors.
• Vocational rehabilitation is defined as
“a multi-professional evidence-based
approach that is provided in different
settings, services, and activities to
working age individuals with health-
related impairments, limitations, or
restrictions with work functioning, and
whose primary aim is to optimize work
participation”
• As per the International Labour Organization Recommendation, 1955
Vocational Rehabilitation has been defined as
“Continuous and coordinated process of rehabilitation which involves the
provision of vocational services e.g., vocational guidance, vocational
training, and selective placement designed to enable a disabled person to
secure and retain suitable employment”
 • Vocational rehabilitation agencies, often referred to as
“VR”, are in every state. VR helps people with
disabilities prepare and look for a job. VR was created
out of the Rehabilitation Act of 1973.
Background
• VR programs are run by state agencies. They are
designed to help people with disabilities meet their career
goals. They help people with disabilities get jobs,
whether the person is born with a disability, develops a
disability or becomes a person with disability while
working.
 Vocational Rehabilitation Act, 1973

• The Vocational Rehabilitation Act of 1973 was put in place to correct the
problem of discrimination against pwd in the US.

• Affirmative action programs were established sections 501, 502, 503 and 504.
the title V of vocational rehabilitation act requires private employers with
federal contracts over $2500 to take affirmative action to hire individuals with
a mental or physical disability. While this means that employers must make
reasonable accommodations for disabled employers, it does not mean they
must hire unqualified individuals
 RTW
The primary
goal of VR

SUSTAINE
D RTW
 VR services should be made available to all
disabled persons, whatever the origin and
nature of their disability and whatever their
Scope of VR age, provided they can be prepared for, and
have reasonable prospects of securing and
retaining, suitable employment
 Functions of Vocational Rehabilitation
Providing Assisting Teaching Helping Aiding
• information to • client with • client basic • client to • client to in
clients about the developing a problem develop or obtaining
job market, the realistic view solving and maintain educational
skills and of their skills, coping skills motivation for services, skills
experience abilities and vocational training or the
necessary to limitations services and necessary
obtain and work employment entitlements to
successfully at a obtain
particular job
education and
and the types of
stressors and training (case
rewards management)
associated with
different jobs.
Objectives of Vocational Rehabilitation
Assessment of the
Vocational evaluation
medical, assist in developing
and adjustment of
psychological, rehabilitation plans
PwDs
rehabilitation needs

sponsor physically
Distribution centers for Make referrals to
handicapped
various schemes financial institution for
registrants against
(Scholarship /aids funding self-
notified/identified
/appliance) employment ventors
vacancies
Models of Vocational Rehabilitation
• In a systematic review, Fadyl and McPherson grouped vocational
intervention programmes into three broad models
programme based model
case coordination model
employment model
 • focus mainly on the pre-placement phase including
intensive work skills rehabilitation and intervention
within a structured center-based facility.
• characterized as a train and place model.
• Most commonly, clients attend a structured
Programme- outpatient programme for a number of weeks,
participating in individual and/or group therapies
based models with emphasis on cognitive, behavioural,
psychosocial and/or metacognitive skills as well as
education to families and employers, targeting
return to work goals
• Although programme-based models focus on
addressing impairments, they provide only limited
on-job support and long-term follow-up.
 • contemporary approach to VR
• Rather than provide vocational rehabilitation
sequentially after the medical rehabilitation phase
has been completed, the case coordination
approach involves the early commencement of
Case vocational rehabilitation concurrently with
coordination medical rehabilitation, through the introduction of
a vocational counsellor into the rehabilitation
Model service.
• Programmes are designed to suit specific
individual needs and provide opportunities to
access other vocational rehabilitation elements,
such as work trials or supported employment
programmes through referral to external services
 • developed within the disability field in the late
1970s and then later trialed for applicability to
acquired brain injury.
• Supported employment takes a place and train
approach in which individuals are first placed
Supported into a job and then all the components of
vocational training, counselling and support are
employment applied at the job site while the person is
model actively employed.
• Components of place and train intervention
include sourcing an appropriate work
environment, job placement, job-site training
and advocacy, ongoing assessment and
retention/monitoring.
 Principles of Vocational Rehabilitation
1. Vocational rehabilitation should be initiated without delay and proceed in
conjunction with medical treatment and physical rehabilitation to restore
the workers capabilities as soon as possible.

2. Reasonably necessary vocational rehabilitation assistance will be

provided to overcome the immediate and long-term vocational impact of
the compensable injury, occupational disease or fatality.
3. Successful vocational rehabilitation requires that workers be motivated to
take an active and initiative in their own rehabilitation. Vocational programs
and services should therefore, be offered and sustained in direct response to
the commitment and determination of workers to re-establish

4. Maximum success in vocational rehabilitation requires that different

approaches be used in response to the unique needs of each individual.

5. Vocational rehabilitation is a collaborative process, which requires the

involvement and commitment of all concerned participants.
6. Effective vocational rehabilitation recognizes, within reason, workers
personal preferences and their accountability for independent vocational
choices and outcomes.

7. The gravity of the injury and residual disability is a relevant factor in

determining the nature and extent of the vocational rehabilitation assistance
provided. The board should go to greater lengths in cases where the disability
is serious than in cases where it is minor, including measures to assist
workers o maintain useful and satisfying lives.
8. Where the worker is suffering from a compensable injury or disease
together with some other impediment to a return to work, rehabilitation
assistance may sometimes be needed and provided to address the combined
problems. Rehabilitation assistance should not be initiated or continued when
the primary obstacle to return to work is non- compensable.

9. Vocational rehabilitation services should be provided in a cost- effective

manner.
 1. Vocational assessment
2. Work re-training, education and
counselling
VR deals 3. Work guidance and ergonomic
modifications
largely with 4. Psycho-social interventions (including
vocational orientation and all other
forms of preparation for RTW)
 Vocational Rehabilitation Services

Researching Providing health

Assessment of Helping to set Planning
options based on advice to help
your current state goals interventions
assessments RTW

Finding ways to Helping to self- Referring other Co-ordinating

Managing your
limit the impact manage the people who can people to provide
case
of condition condition help best service

Analyzing and Providing job Ongoing

Career
developing job placement evaluations of
counseling
opportunities services ability to work
• The core ingredients of any VR are the relationship between the client, the
actual or potential employer, the health professionals involved and the
insurer

• There are 3 aspects of VR

i. Preparing disadvantaged young people for the world of employment

ii. Job retention-supporting and maintaining those currently in
employment
iii. Facilitating new work for disadvantaged individuals currently out of
employment and unemployed or on ill-health benefits
• An assessment using multiple measures to determine an individual’s
ability to fulfill the worker roe and identify the most appropriate
occupational category, through an examination of physical, cognitive
and psychosocial abilities.
 Workplace Assessment

Functional Capacity
Evaluation

Work Trial
Vocational Work Related
Rehabilitation Assessment Work Simulation

Physical Capacity
Evaluation

Work Samples

Psychometric Tests
 • An assessment using multiple measures to determine an
individual’s ability to perform the work requirements of:
Specific job tasks or activities
An entire job
Group of jobs
Work- Related Work demands
Assessment
• Purposes:
Diagnose, determine need for intervention
Determine individual’s ability to perform work roles,
activities, tasks and skills
Determine sincerity of effort and consistency of effort
Document outcome, achievement of goals
Develop treatment resources and research
1. Workplace Assessment
focus on “the interaction between the worker, the job and the
environment” in order to identify suitable duties, including an
overview of the physical environment, job demands and working
conditions”
Occurs at the worksite
Involves injured worker and current employer
Usually, 1-3 hours duration
2. Functional Capacity Evaluation
A one-time evaluation using measures to determine maximal
performance of physical demands and skills including:
Tolerances ( sitting, standing, walking, kneeling,
stooping/bending, crouching/squatting, crawling and
climbing)
Manual Handling ( lifting, carrying, pushing and pulling)
Upper Limb Function (reaching and manual dexterity)
3. Work Trial
Assist in both building and demonstrating capacity-is used when
you are looking for a new employer or an existing employer does
not have suitable duties available
Occurs at the worksite
Different/ new employer
May be from 1 to 12 weeks duration
4. Work Simulation/ Situational Assessment
Simulated work activities and tasks performed in a controlled
clinical environment
Good for assessing psychosocial aspects and endurance
5. Physical Capacity Evaluation
A one-time evaluation, using measures to determine the maximal
performance of isolated physical attributes
• Examples:
static and dynamic muscle strength
Flexibility
Balance
Coordination
cardiopulmonary endurance
6. Work Samples
Standardized tests based on well-defined work activity involving
tasks, materials and tools associated with a job or cluster of jobs
• Usually incorporated with FCE
Actual job sample
Simulated job sample
Cluster trait sample
Single trait sample
7. Psychometric Tests
Tend to be predominantly pen and paper tests
Examples:
 intelligence tests
interest inventories
 Process of Vocational Rehabilitation
Referral Services

Evaluation

Interdisciplinary interaction for Rehabilitation plan

Service delivery towards vocational rehabilitation

 I. Referral Services

• May be referred by Hospitals, other professionals in the field, organizations

working in the community, by friends or self-referral
• Data collection relation to personal details such as Name, Father/ Guardian’s
name, address, family details and background, economic status, particulars of
impairment, date of onset of disability, educational attainment, skills if any
(formal, non-formal or informal), usage of assistive devices- constitute the
preliminary data about the pwd.
• Also evaluates whether the approaching pwd is covered by the aims and
objectives of the Agency.
 II. Evaluation

• Evaluation means “the making of a judgement about the amount, number or value of
something; assessment”
• The Range of Evaluation may be explained through the acronym “SKAPATI”
S- SKILL
K- KNOWLDEGE
A- ABILITY
P- PHYSICAL CAPACITY
A- APTITUDE
T-TRAITS
I- INTERESTS
Medical evaluation
• Pwd is referred for medical/psychological evaluation by a specialist

• Specialist would be requested to provide information on onset of disability,

existing conditions of impairment, whether temporary or permanent,
residual abilities, prohibited areas of jobs, if any, prognosis and medical
rehabilitation
Psychological Evaluation
• Involves more than psychological testing.

• Includes the client's past behaviour as well as conclusions drawn from

observations collected during initial interview and outside contacts.
Vocational Evaluation:
• Most important component of vocational rehabilitation that matters to the
objective of the VRW.

• Defined as the process of gathering, interpreting, analyzing and

synthesizing all vocationally significant data that is medical, social,
psychological that have been collected regarding the concerned PWD and
relating them to occupational requirements and opportunities.

• Data is collected and the results summarized with set criteria and compared
with set criteria to draw conclusions
• Two types of evaluation
Formative ( during immediate intervention program)
Summative (long term results and at final stage)

• Is an educational process in which a client obtains greater self and work

knowledge through participation in work activities designed to evaluate
vocational skills, interest and abilities.

• Occurs over a time ( days/week/weeks) and evaluated with varying work-

related demands and environments and consists of systematic behavior
observation and recording work performance, work behavior etc and when
adaptive and/or transferable skills are questionable or unknown.
Tools of Vocational Evaluation:

• Transferable skills, vocational interests, worker characteristics and behaviors,

academic abilities and potential, learning styles, work aptitudes and abilities,
suitable employment alternatives

1. Integrate the long separated “tracks” of academic and vocational education

2. Link schooling and the demands and realities of workplace
3. Develop programs to closely coordinate secondary and post school
education with employers
 LEISURE ACQUIRED VOCATIONAL
ACTIVITIES SKILLS POTENTIAL

PHYSICAL VOCATIONAL PERSONAL

ABILITIES EVALUATION TRAITS

SOCIO- INTEREST EDUCATION

ECONOMIC AND AND
FACTORS APTITUDE TRAINING
 III. Rehabilitation Plan

• Based on the evaluation and discussions with the other professionals involved
and the pwd himself, Vocational diagnosis is arrived at and a Rehabilitation
Plan is drawn that includes
Physical restoration
Psychosocial rehabilitation including behavior modification
Vocational rehabilitation plan to decide on vocational guidance
vocational/skill training, income generating activity
 IV. Rehabilitation Process

• Physical Restoration: medical or surgical intervention to stabilize

impairment, fitting of prosthetics or orthotic appliances to minimize
disability and/or increase mobility.
• Psychosocial rehabilitation: individual counselling to help him accept
disability, attain desirable work behavior, change attitudes etc., to improve
cognitive abilities
• Vocational counselling: guide a help the pwd select a suitable job based on
the evaluation
• Institutional Training: guide the pwd to choose suitable vocational skills
and training
• Adjustment Training: help the pwd upgrade skills to compete for
economic activity. For example: A person may have knowledge and skills
for stitching clothes but may not cutting. He would learn this skill to be a
full-fledged Tailor

• Retraining: An employed person acquired impairment during work or

otherwise and needs training in similar skills or other skill to enable him
restore the job

• Social Rehabilitation: Help in finding residential home, or either into

marriage, participate in National or international sports/skill competitions.
• Adaptive education: adult education, learn sign language, Braille, appear for
distance learning programs to increase rehabilitation prospects

• Vocational Training: Skill development through informal, non-formal or

formal institutions to make him eligible for jobs in the market

• Job Placement: Open employment, self employment, supported employment,

sheltered workshop, home bound employment, self help groups, cooperative

• Follow up and Case Closure: Rehabilitation is not complete as long as the

pwd needs it. Regular follow up visits are made and recorded to ensure
complete rehabilitation.
 VR services

• The individual or their representative must:

1. Complete and sign a VR agency application form OR complete a common

intake application form in a One-Stop center requesting vocational
rehabilitation services, or otherwise request services
2. provide the information necessary to initiate an assessment to determine
eligibility and priority for services
3. be available to complete the assessment process
 Eligibility

• All individuals with disabilities are eligible for VR services.

1. who has a physical or mental impairment

2. whose impairment substantially interferes with the ability to get a job
3. whose impairment requires VR services to prepare for, secure, retain, or
regain employment
4. and intends to achieve an employment outcome
 Referrals

• Referrals may be made by the individual or representative in person, or by phone,

paper, email, or other method.

• Others can also refer, including but not limited to: schools, community rehabilitation
programs, employers, friends, and service providers.

• VR agencies must have a process in place to ensure that individuals expressing

interest in VR services are able to access the program and apply for services in a
timely manner.
 Do VR users pay for services?

• Some states provide VR services at no charge to people who use the services,
while others may require a contribution based on financial means testing.

• Each state must have a written policy detailing how financial means are tested and
how costs are shared with participants.

• However, states are not allowed to charge participants for: assessment services,
vocational rehabilitation counseling and guidance, referral and other services, job-
related services, or personal assistance services.
 How is eligibility for VR services determined?

• A VR counselor determines whether people meet the eligibility criteria, based on a

review of existing records which include: the VR counselor’s observations,
education records, information provided by the individual or the individual’s family,
particularly information used by education officials, and determinations made by
officials of other agencies.
• If there are still questions about the person’s functioning level, additional data is
collected through trial work experiences, assistive technology devices and services,
personal assistance services, and any other support services that are necessary to
determine whether an individual is eligible.
• States may also provide for additional assessment and diagnostic services, such as
sending an applicant to a specialist.
 How are decisions made about services?

• If a person is deemed eligible for VR services, the next step is to create an Individualized
Plan for Employment (IPE).
• The IPE specifies an intended employment outcome for a person - meaning whether the goal
is for the person to work in full-time or part-time competitive or supported employment, or
another setting such as self-employment. If appropriate, the IPE outlines how supported
employment will be provided and whether post-employment services will be provided. The
IPE must also include the types of services required by the individual, the duration of
services, who will provide the services, and criteria for how progress will be evaluated.
• Once the specified duration of services is complete, or if an individual no longer needs help,
services are terminated. The individual may be eligible for certain post-employment services
if specified in the IPE.
In India Vocational Rehabilitation as a subject was introduced as
extension of medical rehabilitation in some hospitals in 1967 and
separately under the Ministry of Labour the Govt of India in 1968
as Research Project supported by Veterans Rehabilitation
Administration (VRA) of the US Govt. and later was converted as
social and rehabilitation services and now named rehabilitation
services administration (RSA).
• Two vocational rehabilitation centers for handicapped (VRCs) were
started at Hyderabad and Bombay in 1968 as Research Projects and
on completion and withdrawal of Us, later extended to other states as
part of Govt of India effort to rehabilitate pwd.

• At present there are 21 such centers in the country almost one in each
state.
 Vocational Rehabilitation Centers (VRCs) In India
1. I/C VRC for Handicapped, ATI Campus,Vidya Nagar, Hyderabad-500 007
2. Plot No. 1,2, 5 & 6, adjacent to Indira Gandhi Ayurvedic College & Satya Sai Women’s
College At: Jagamara, PO: Khandagiri, Bhubaneswar-751030.(Orissa)
3. VRC for Handicapped, Old Women Building, DECT Campus, A.K.Azad Road, Rehabari
Guwahati-781 008. (Assam)
4. VRC for Handicapped, ATI Campus, Gill Road Near Arora Talkies, Ludhiana-141 003,
(Punjab)
5. Shri M.P. Pathak Psychologist (Officiating) VRC for Handicapped, A/84, Plot No.1, Gandhi
Vihar Police Colony, Anisabad, Patna-800002. (Bihar)
6. VRC for Handicapped, 4S-A/23, Jawahar Nagar, Jaipur-302004. (Rajasthan)
7. VRC for Handicapped (Women), After Care Hostel Building, Pensionpura, Vadodara-390002.
(Gujarat) 
8. VRC for Handicapped, CTI Campus, Guindy, Chennai-600 032.(T.N.) 
9. VRC for Handicapped, ITI Campus, Kuber Nagar, Ahmedabad-382340 (Gujarat)
10. Shri L.K.Varte (Officiating) VRC for Handicapped, Abhoy Nagar, Agartala-799 005, Tripura
11. VRC for Handicapped, A-417, 1st-B-Main, 1st Cross, 1st Stage, Behind Peenya Police
Station,Peenya, Bangalore-560058.(Karnataka)
12. VRC for Handicapped, ATI Campus, Udyognagar Nagar, Kanpur-208022.(U.P.)
13. VRC for Handicapped, Nalanchira, Trivandrum-695 015.(Kerala)
14. VRC for Handicapped, Block: EN/81, Sector-V, Salt Lake City,, Kolkata-700 091.(W.B.)
15. VRC for Handicapped, Napier Town,Near Bus Stand and Nab Bharat Press, Jabalpur-482 001,
16. VRC for Handicapped, Gogji Bagh, Government Polytechnic Building, Srinagar-
190008(Jammu & Kashmir)
17. VRC for Handicapped, ATI Campus, V. N. Purav Marg, Sion, Mumbai-400 022. (Maharashtra)
18. VRC for Handicapped, 116, Lazar Koil Street, Dubrayapet, Puducherry- 605 001
19. VRC for Handicapped, Plot No. 9-11, Karkar Dooma, Vikas Marg, Delhi-110092,
20. VRC for Handicapped, Mohalla Bagh Mataji, Near Rotary Chowk, Una-174 303 (
Himachal Pradesh)
21. C/o Coaching cum Guidance Centre for SC/STs, H-Block, Jawan Bhawan, Main Road, Ranchi-
834001, Jharkhand
 The main purpose of
these centers is to They also sponsors
evaluate the candidates to potential
capabilities of disabled employers
clients
The main objectives of VRC:

Vocational evaluation Assist in developing

Assessment of the
and adjustment of the rehabilitation plans
medical, psychological,
physically handicapped depending upon the
rehabilitation needs
persons specific needs

Sponsor physically Act as distribution

Make referrals to
handicapped centers for various
financial institution for
registrants against schemes like
funding self-
notified/identified Scholarship/aids and
employment ventures
vacancies appliances
 • Lawyer, Simon, who had been diagnosed with
depression and anxiety.
• 42 years old with a wife and children. He was a
CASE STUDY senior partner in a law firm and was highly successful
in his job. He was also extremely anxious about
I failing or not succeeding in some way. Although
Simon didn’t want to practice law anymore, he didn’t
know what else he could do and this was playing on
his mind and affecting his performance at work.
Simon was finding it extremely stressful, and he had
begun to avoid taking on certain types of cases.
• When he came to VRC, Simon was no longer
sleeping, he would spend his nights awake, he had
started developing unhealthy coping strategies and
felt that his world was crumbling around him.
Assessment
• identify the primary issues and barriers. what was needed to
be put in place to overcome or minimize those barriers and
enable Simon to succeed again
Intervention
• Six-month period. aim and focus was on supporting him to
re-engage with the tasks and activities he was finding
challenging. As time went by, contact with him was reduced
gradually in a planned way. Simon became more confident in
drawing on his own personal resources again.
• looked at adapting and changing the way Simon undertook
tasks relating to work. helped him to restore some of the
personal strategies that had worked for him in the
past. suggested ways of modifying his environment and
routines to help with sleep. So, looked at all aspects of
Simon as an individual and the world in which he needed to
function.
Outcome
• The outcome was that Simon resumed practising
law. His sleep had returned to a healthy pattern
and family life was satisfying and enjoyable. He
had learnt how to be selective about the cases he
took on. He was able to recognise that it was his
choice to do so and he was not incompetent or a
failure for exercising this choice.
• His comment at the end was “this is the first time
that I actually feel successful.”
 • Jack was involved in a multi-vehicle accident several
years prior in which he sustained multiple orthopedic
injuries as well as a traumatic brain injury.
CASE STUDY Client History
II • Prior to the accident, Jack was working as a
pharmaceutical sales manager. Jack suffered from a
serious brain injury, various orthopedic, and
musculoskeletal injuries. Following a lengthy hospital
stay he required in-patient rehabilitation. He continues
to experience hearing loss, balance problems, memory
and organizational problems, and word retrieval
difficulty. He is unable to make decisions quickly or
solve problems under stress. Jack has been unable to
meet the demands of his pharmaceutical sales job and
has been out of work for several years. His goal is to
return to his previous position.
Analysis
• It was determined Jack would be unable to return to
competitive employment for the foreseeable future.
 vocational specialist helped him enroll in a sheltered
workshop program for designed for TBI clients and a part-
time volunteer opportunity was identified. He started
making money at the workshop and feels he has made
progress.
Outcome
• Through placement in a sheltered workshop environment,
volunteer activities, and extensive rehabilitation, Jack’s
providers feel he is a candidate for supported employment
in the future. The vocational counselor provided a report
on potential lost earnings over the course of the client’s
lifetime as well as future earnings capacity.
Process
• vocational specialist met with Jack and discussed Jack’s
strengths and weaknesses since the accident.
• Jack’s records were requested, and a thorough review was
completed. Jack underwent testing to determine his
computer skills, verbal skills, and cognitive endurance.
• The vocational counselor noted Jack's ability to perform
repetitive data entry tasks, filing, and written
documentation. She noted Jack becomes distracted and
performs slowly. They agreed to start with volunteer
positions to give Jack a chance to use his skills in a real life
setting.
• A volunteer position at the local "Y" was located. Jack
began helping in the customer service department. He
performed simple tasks such as filing, managing the sign in
sheet, and data entry. His work increased from 2 hours per
week to 8 hours per week.
Legislative frameworks in India around
Disability
Government Schemes- Poverty Reduction
Schemes/Livelihood Schemes
 • Although most pwd are able to maintain the capacity to
make decisions concerning their needs and life-styles, they
may need time to be educated and empowered about new
roles and options in learning to cope with disability.

• Vocational rehabilitation is a positive and successful

SUMMARY response to the prevention and shortening of prolonged
work disability.

• It can accelerate return to work, induce an increase in work

productivity and the participation of disabled people.

• It can help in reducing premature retirement and in

diminishing the direct and indirect costs of a disease.
 • Escorpizo R, Brage S, Homa D, Stucki G. Handbook of
vocational rehabilitation and disability evaluation.
Springer International Pu; 2016.

• Harley DA, Ysasi NA, Bishop ML, Fleming AR.

Disability and Vocational Rehabilitation in Rural Settings.
REFERENCES
Springer; 2018.

• Waddell G, Burton AK, Kendall NA. Vocational

rehabilitation–what works, for whom, and when?(Report
for the Vocational Rehabilitation Task Group). TSO; 2008.

• Vocational Rehabilitation (Disabled)Recommendation,

1955 (No. 99)