Policy Guidelines for Vocational Rehabilitation Assessment, Evaluation and Plan

Vocational rehabilitation providers can be approved by the Agency to offer comprehensive rehabilitation services to Michigan’s injured workers.  In becoming approved, providers must meet and maintain certain standards outlined by the Agency.  At the heart of the standards, however, are core knowledge, skills and abilities that should already be ingrained in every trained rehabilitation counselor.  

There may also be times when the counselor’s reports come under scrutiny during the informal dispute resolution process or at the magistrate trial level.  These hearing officers will look for evidence of comprehensive rehabilitation evaluation, assessment, and planning. Therefore, approved vocational counselors are strongly encouraged to adhere to the guidelines below as part of their usual routine when providing initial and ongoing vocational services.  The guidelines set forth a general outline of the relevant areas which should be addressed by the rehabilitation practitioner when developing the evaluation and plan.

EVALUATION & ASSESSMENT

The most crucial aspects of the vocational process are comprehensive evaluation and assessment.  These terms, although often used interchangeably, can actually be defined separately.

The vocational evaluation is part of the overall vocational assessment process and is the specific method or process of collecting all relevant data on an individual (e.g., the score of a test, observation, interview, etc.) which contributes to the overall vocational assessment.  Above all, the evaluation process should always include an “in-person” initial interview with the injured employee.

Vocational assessment is an ongoing process that seeks to bring together all relevant objective and subjective data in order to analyze and plan an individualized course of action.  The ultimate goal of vocational assessment is to objectively determine an injured worker’s employability, identify realistic return-to-work opportunities, and to develop appropriate vocational recommendations based on the individual’s functional status, education, vocational history, and transferable skills.

Vocational Evaluation

The first step in the evaluation process is the initial interview. This is the first in-person meeting between the counselor and client. This initial meeting serves to obtain relevant background information and educate the injured worker about the vocational rehabilitation process, as well as his or her rights and responsibilities. It also serves as the beginning of the client-counselor relationship with an emphasis on client involvement throughout the entire vocational rehabilitation process.

An initial interview should include the following components:

• Explanation of vocational counseling purpose, services, and objectives.

• Review of the Professional Disclosure Statement.

• Medical evaluation including review of any medical diagnosis, prognosis, treatment modalities, medications, restrictions, and residual ability levels.

• Vocational history including military experience, job duties, transferrable skills, worker traits, wages earned, and reasons for leaving.

• Educational history, both formal and informal.

• Injured worker’s interests and aptitudes.

• Transferable Skills Analysis

• Counselor’s observations and impressions.

• Next steps to be taken and specific recommendations.

Upon completion of the initial interview, the rehabilitation counselor should gather up-to-date medical records that weren’t provided during the interview, determine if psychological testing and/or additional medical examination is warranted, schedule any additional vocational/psychometric testing, and arrange for more in-depth work evaluations if warranted. Examples of these include on-the-job evaluations, situational assessments, or work adjustment.

Vocational Assessment

The vocational assessment is where all of the evaluation information regarding the client's skills, aptitudes, interests, and physical abilities are analyzed to determine the need for and feasibility of rehabilitation services. It is the rationale used to decide the direction of continued vocational services. A complete and comprehensive assessment will maximize an injured worker’s potential employability within a suitable position compatible with his/her skills, interests, and capabilities. Factors to include when considering the need for and feasibility of rehabilitation may be:

• Vocational strengths/weaknesses.

• Medical stability.

• Injured worker’s adjustment to the disability and functional abilities.

• Testing results.

• Labor Market Survey results.

• Transportation and housing needs.

• Available support network and additional psychosocial aspects affecting employment.

The vocational assessment is the objective documentation that is necessary for developing an Individualized  Written Rehabilitation Plan that may entail a return to work with the same employer, another employer, retraining, or self-employment.

INIVIDUALIZED WRITTEN REHABILITATION PLAN

If the vocational evaluation and assessment process determines that continuing services are both needed and feasible, the next step is to develop the Individualized Written Rehabilitation Plan (IWRP). The purpose for writing an IWRP is to outline, in detail, the steps necessary for an injured worker to return to work. Each IWRP should be specifically tailored to the individual and be written so that the responsibilities of each party to the plan are clearly identified. Drafting of the plan is a collaborative effort, with full client participation throughout the process.

As noted above, every IWRP will vary, as they are customized to the individual client.  However, each plan should include, but not be limited to, the following factors:

• General background and demographic information.

• Summary of medical information and restrictions.

• Vocational history including specialized training, certificates, or skills.

• Specific vocational goals, expected timeframes to completion, approximate costs, and procedure for measuring progress.

• Services necessary to reach the job goal, the providers of the services, and funding sources.

• Psychosocial concerns and other possible barriers to employment such as transportation and assistive technology issues.

• Clearly defined responsibilities for all involved parties.

• Summary of vocational testing results.

• TSA/Labor market survey results (if performed).

• Description of any post-employment supports necessary for job retention.

The IWRP is the keystone of the vocational rehabilitation process.  It should be created in collaboration with the injured worker.  It is a “living document”, and should be reviewed/revised with the client at maximum 90-day intervals.  For example, direct job placement services that continue beyond 90 days without success should be re-evaluated to determine if plan goals are in alignment or if additional support services such as training are warranted. 

Following the guidelines as outlined above should provide you and your client a solid and comprehensive foundation to build upon as you strive for successful attainment of the vocational rehabilitation goals.