employment and finance decisions / resources after brain injury robert fraser, ph.d., crc university...
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![Page 1: Employment and Finance Decisions / Resources After Brain Injury Robert Fraser, Ph.D., CRC University of Washington TBI Model Systems Director, Neurological](https://reader034.vdocuments.site/reader034/viewer/2022051621/5697bf8f1a28abf838c8d993/html5/thumbnails/1.jpg)
Employment and Finance Employment and Finance Decisions / ResourcesDecisions / Resources
After Brain InjuryAfter Brain Injury
Robert Fraser, Ph.D., CRC
University of Washington TBI Model Systems
Director, Neurological Vocational Services
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• Can I stay on the job? ______________________________________________
• How am I doing physically in relation to job performance and fatigue?______________________________________________
• Do I have difficulties in thinking or with memory? ______________________________________________
• Are there other difficulties affecting my working? ______________________________________________
• Do I think I could perform with accommodation? ______________________________________________
• Do I need to disclose to my employer? ______________________________________________
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Accommodation Accommodation Self-Effectiveness:Self-Effectiveness:
• An individual with TBI:– Knows accommodation needs.– Understands accommodation under ADA.– Is encouraged to approach employer.– Role plays, following a model, an
accommodation presentation.
• If accommodation needs are not known (including NP), seeks consultation.
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Who Can Be an Who Can Be an Accommodation Consultant?Accommodation Consultant?
• A Vocational Rehabilitation Counselor
• A Speech and Language Pathologist
• A Neuropsychologist
• An Assistive Technologist
• Job Accommodation Network (JAN)
• Disability and Business Technical Assistance Center (DBTAC)
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Reasonable AccommodationsReasonable AccommodationsA Categorical Perspective:A Categorical Perspective:
• Procedural Accommodations
• Work Station Accommodations
• Assistive Technology
Warren (2000)
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Procedural Accommodations:Procedural Accommodations:
• Come to Work Early – difficult activities first, least complex last.
• Paid Co-Worker as Mentor – can best mentor on critical activities in early AM. Co-worker can actually handle critical incidents of a complex nature which slow worker down.
• Co-Worker Training Method – “Tell, Show, Watch, and Coach.”
Curl et al. (1997)OR:
• Have Home Supervisor “Run Through” a work sample.
• Job Coach – transitioning to Paid Co-Worker as Trainer.
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Procedural Accommodations Procedural Accommodations (cont’d.):(cont’d.):
• Reduce distractors – hold calls until certain segments of the day.
• In general, reduce disruptions / distractors - if disrupted, yellow “sticky note” or record of what one was doing.
• Reduce cognitive fatigue – rest breaks, lunch nap.
• Use priority lists – check lists.
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Procedural Accommodations Procedural Accommodations (cont’d.):(cont’d.):
• In general, do least complex work last.
• Politely take some attentional control – ask that presentor “slow down” the speed at which information is being conveyed.
• Decreased workday or flex time.
• Restructure job.
• Flex Time / Telecommute
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Work Station Modification:Work Station Modification:
• Work Product coming to station is optimal / simplified.
• Work Station is well organized (location of equipment, desk space, color-coded tool sequence, etc.).
• Telecommuting (home work
station).
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Assistive Technology:Assistive Technology:
• Recorded / Dictated Information
• Faxed Information
• E-mailed / Phone-mail messages
• Personal Digital Assists with alarms
• Microsoft Outlook calendar function / message sorting function
• Voice-activated Software
• Tailored Computer Software Programs for Customer Service, etc.
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Employer Disclosure ScriptEmployer Disclosure Script
My script:
________________________________________________________________________________________________________________________________________
Clarity!Succinct!
Practice!
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Need to Stabilize Medically, Need to Stabilize Medically, What are My Options?What are My Options?
• Vacation, Sick leave
• Family Medical Leave Act
• Short-Term Disability
• Unpaid leave –
– Be Creative?
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I Need to Find a New Job,I Need to Find a New Job,What are My Resources?What are My Resources?
• State DVR (Division of Vocational Rehabilitation)
• WorkSource: State Employment Agency
• Professional Trade Associations
• College / Training Facility Placement Offices
• Professional Placement Services
• Websites – UWMSRRTC, Craig’s List, Indeed.com, NWjobs
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State Vocational RehabilitationState Vocational Rehabilitation
• Go prepared with Med / NP documentation.
• May need to wait – order of selection.
• Persistence ! Persistence ! Persistence !
• Work with a “name.”
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What Can State Vocational What Can State Vocational Rehabilitation Really Do for You?Rehabilitation Really Do for You?
• Vocational Assessment• Neuropsychological Testing• Specialty Consultations, not covered by insurance to
include psychotherapy• Retraining• Direct Job Placement / Tryouts• OJT Money• Sundries (transportation, clothing for interviews, etc.)• Assistive Technology Consultations
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1993 U.S. Department of Labor 1993 U.S. Department of Labor Waiver on Unpaid WorkWaiver on Unpaid Work
• Vocational exploration 5 hrs.
• Vocational assessment 90 hrs.
• Vocational training 120 hrs.
Total: 215 hrs.
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In Addition to the Non-Paid In Addition to the Non-Paid Tryout, What Other Incentives Tryout, What Other Incentives Might You Offer an Employer?Might You Offer an Employer?
• Work Opportunity Tax Credit
• On-the-job-training
• Selective Certification
• Job Coaching / Co-Worker as Mentor support
• Barrier removal tax credits / deductions
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Employment Resources:Employment Resources:
• Do some temporary work (temp-to-perm).
• Networks – Church, Community, etc.
• Chambers of Commerce.
• Fraternal / Charitable Organizations (e.g., Rotary), etc.
• Career Counselors.
• Projects With Industry (NVS).
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Reducing Social Isolation – Reducing Social Isolation – Mood Management:Mood Management:
• Health club – YMCA / YWCA scholarships
• Volunteer work
• Support groups
• Religious groups
• Community groups – Special interests
• Exercise-related
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Securing Social Support:Securing Social Support:
• Finding friends
• Bartering for support
• Tapping volunteer resources (United Way, seniors, church groups, high school, community service)
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Transportation:Transportation:
• Bus pass
• City / County Access programs
• Tapping volunteer sources
• Neighbor / Community drivers
Don’t Be Shy Here !
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Doing Your Own Work!Doing Your Own Work!
• Do you have your specific job goals identified?
• Geographical area – even neighborhood specific?
• Your important work values identified?
• Potential contacts who can help you secure position?
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It is in One’s Best Interests It is in One’s Best Interests to Utilize All Medical, to Utilize All Medical,
Neuropsychological and Neuropsychological and Financial Status Info Financial Status Info in Making Pro-Active in Making Pro-Active
Vocational Steps!Vocational Steps!
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Disclosure to the Employer?Disclosure to the Employer?
• On the Job Application• During an Interview• After the Interview• After Offered the Job• After You Start Work• After a Disability Relapse
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Getting Informational Interviews Getting Informational Interviews – A Systematic Process– A Systematic Process
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Informational Interview Informational Interview Format:Format:
• Be able to describe your experience / skills, qualities as a worker, and your goals (3-4 minutes).
• Have questions prepared to ask the interviewer – read annual report, web information, key info about company.
• Ask for résumé feedback in relation to company needs.
• Would any company positions fit now or in the future?
• If not, potential external contacts?
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Finances:Finances:
• DSHS-GAU• SSI• SSDI• Emergent Funds• Short / Long-Term Disability• Food Stamps• (Salvation Army, Religious Organizations,
Food Banks)
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Social Security Issues:Social Security Issues:
• 9-month Work Trial (SSDI)
• PASS plan (SSDI)
• IWRE plan (SSI)
• AmeriCorps
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Can’t Work – Applying for SSDI ! Can’t Work – Applying for SSDI ! What are the Issues?What are the Issues?
• Maintaining Insurance
• Maintaining Your Income Stream
• Securing SSDI and Working Part-Time
< $940 / month
• Individual Work-Related Expenses (IWRE) Lowers Income
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Social Security Disability Social Security Disability Income (SSDI):Income (SSDI):
• Based upon the number of credits you’ve earned, if over 31 you need 20 credits in the last 10 years (earn up to 4 credits per year).
• SSDI is often not granted with the first application.
• When granted, benefits begin at 6 months from when you became disabled.
• If no other coverage, awarded Medicare benefits in 2 years.
• IWRE Expenses – can earn < $940.
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Social Security Income (SSI):Social Security Income (SSI):
• Available if you haven’t worked / don’t qualify for SSDI
• Excess savings / income can be put in an Income Cap Trust for you to qualify (not exceed cut off) for Medicaid
• Monthly payment ~ $564• PASS Plan for work-related costs subtracted
from earnings
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Financial Debt:Financial Debt:
• Bankruptcy, Chapter 7
• Bankruptcy, Chapter 13
• Debt Consolidation
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Assess Your Financial Picture!Assess Your Financial Picture!
Think Out of the Box!Think Out of the Box!
Budget!Budget!
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Benny the PlannerBenny the Planner vs. vs.
Gerry the Non-PlannerGerry the Non-Planner
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In Closing, Remember In Closing, Remember Accommodations Resources:Accommodations Resources:
• JAN: www.jan.wvu.edu
1-800-526-7234
• DBTAC: 1-800-949-4232
• EMPLOYMENT DISCRIMINATION:
www.eoc.gov
1-800-669-EEOC (-3362)