Effective Vocational Rehabilitation Can Return Disabled Workers to Workforce, Cut Costs

Nancy Grover

Sarasota, FL (WorkersCompensation.com) – While the overall unemployment rate fell between February 2018 and 2019, it actually increased among persons with a disability during that same period – from 8.6 percent to 9.1 percent. The costs of nonfatal disabling workplace injuries can be enormous, with recent estimates exceeding $58 billion annually, or more than $1 billion per week.

Using a team approach to vocational rehabilitation can help disabled persons reenter the workplace, reduce the costs to payers, and help the injured worker return to function and productivity, an expert says.


Vocational rehabilitation (VR) is defined as a state agency that provides assistance to individuals with disabilities to secure employment, regain employment or retain employment that is consistent with their strengths, abilities, and informed choice. Its purpose is to empower persons with disabilities to maximize employment, achieve economic self sufficiency and independence, and realize full inclusion and integration into society.

In an ideal world, both the employer and injured worker want the employee to return to that workplace and the VR counselor works with both to smooth the process. However, that’s not always realistic.

“The employer may be hesitant to have the injured worker return with a permanent disability; he may be afraid the accommodations may cost too much or disrupt the environment, or not have a good understanding of what the permanent disability will allow the injured worker to do,” said Pamela Rast, professor of Athletic Training, Program Director & Kinesiology Department Chair at Texas Wesleyan University. “The injured worker may be hesitant to return with certain limitations. The VR counselor might have limitations with having the two be hesitant about that return-to-work situation.”

All the while the expenses escalate, Rast said. During a recent webinar produced by Genex, Rast said the average cost for a construction injury with more than 5 days away from work is more than $189 million per week. Serious non-fatal injuries among healthcare workers cost $99 million per week, with back injuries alone costing more than $20 billion annually. And a traumatic brain injury can incur costs between $600,000 to $1.8 million over the person’s lifetime.

The Americans with Disabilities Act requires organizations with at least 15 employees to provide reasonable accommodations to qualified individuals, with certain exceptions. The ADA defines a person with a disability as someone “with a physical or mental impairment that substantially limits a major life activity without consideration of any mitigating measures taken to minimize the effect of the impairment.” A “qualified” individual with a disability is “one who can perform the essential functions of the job with or without reasonable accommodations or meets eligibility requirements for the program or service in question.”

The Process

The VR counselor follows the approved RTW hierarchy. The best case scenario is for the injured worker to be able to return to the same job with the same employer. At the lower end of the spectrum is to go to a different job with another employer.

The VR process begins when it is clear the injured worker will not be able to do his previous job. A comprehensive job analysis must be completed so all stakeholders understand the tasks involved in the previous job.

While the injured worker is recuperating, the VR counselor works with him to establish his past work history. Working with a nurse case manager and adjusters as well as the injured worker, the counselor may oversee or conduct:

  • Vocational testing
  • Work evaluations
  • Schooling
  • Transportation

The counselor also organizes on-the-job training situations and ensures the injured worker is job ready. “Some injured workers who have been at the same job for a while may not have had to apply for a job. The process can be so different,” Rast said. “The VR counselor can help with resume preparation and job application completion. They can help with interview preparation.”

Using job analyses and task assessments helps determine the jobs for which the injured worker may be a good fit. There is also a job modification assessment.

The VR counselor assesses the injured worker’s transferable skills, whether related to past work, hobbies/interests or life experiences. The counselor also helps the injured worker identify two to three job goals and conducts labor market research to determine if and where such positions exist and whether they are feasible for the injured worker.

The ultimate goal is to have the injured worker placed in a job. “It doesn’t really end with the injured worker finding a job,” Rast said. “There should be follow-up with the injured worker and the employer. The goal is to ensure the job placement is successful and that the injured worker can be successful within that environment.”