DRAFT
JWOD Guide
To
Medical Documentation
and
Competitive Employment
Evaluations
DRAFT
Table of Contents
JWOD Requirements
Definition of Severely Disabled
Documentation Requirements
Normal Competitive Employment
Medical Documentation
3
3
4
4
5
Severely Disabled and not Competitively Employable Assessments
Minimum Acceptable Standards
Competitive Employment Evaluation
Initial Assessments
Annual Assessments
Examples of eligibility determinations
7
7
8
10
11
12
Discussion of Commonly Seen Disabilities in the JWOD Program
20
Frequently Asked Questions
34
Glossary of Terms
37
Examples of Acceptable Evaluations
39
Index
48
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JWOD Requirements
For a nonprofit agency to participate in the JWOD Program 75 percent of its total
direct labor hours must be performed by people who are blind or severely
disabled. Therefore, for an agency to participate successfully in the JWOD
Program it must understand the Committee’s definition of severely disabled and
the Committee’s requirements for documentation of those individuals who are
being counted toward the direct labor ratio.
Definition of Severely Disabled
The Committee’s regulations (41CFR51) define severely disabled as:
Other severely handicapped and severely handicapped individuals
(hereinafter persons with severe disabilities) mean a person other than a
blind person who has a severe physical or mental impairment (a residual,
limiting condition resulting from an injury, disease, or congenital defect)
which so limits the person's functional capabilities (mobility,
communication, self-care, self-direction, work tolerance or work skills) that
the individual is unable to engage in normal competitive employment over
an extended period of time.
(1) Capability for normal competitive employment shall be determined
from information developed by an ongoing evaluation program conducted
by or for the nonprofit agency and shall include as a minimum, a
preadmission evaluation and a reevaluation at least annually of each
individual's capability for normal competitive employment.
(2) A person with a severe mental or physical impairment who is able to
engage in normal competitive employment because the impairment has
been overcome or the condition has been substantially corrected is not
"other severely handicapped" within the meaning of the definition.
Therefore, to be considered eligible to count toward the direct labor ratio, an
individual must be disabled to the extent that it affects one of their functional
capabilities to the point that the individual is not capable of engaging in
competitive employment.
The Committee’s definition is only one of many definitions used by the Federal
Government. In July 2003 the Interagency Committee on Disability Research
compiled a list of Federal Statutory definitions of disability. There were a total of
67 laws listed that dealt with various issues such as civil rights, Education,
employment, and housing. The Committee’s definition is unique, but shares
common themes with a number of other Federal definitions. For those
interested, the following link provides a complete list of the definitions:
http://www.icdr.us/documents/definitions.htm#civil
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Documentation Requirements
Section 4 of the Committee’s regulations specifies the requirements that a
nonprofit must meet to enter and maintain its qualifications in the JWOD
Program. In section 4.3(c) on maintaining qualifications it states:
Each nonprofit agency employing persons with severe disabilities
participating in the JWOD Program shall, in addition to the requirements of
paragraphs (a) and (b) of this section, maintain in each individual with a
severe disability's file:
(1) A written report signed by a licensed physician, psychiatrist, or
qualified psychologist, reflecting the nature and extent of the disability or
disabilities that cause such person to qualify as a person with a severe
disability, or a certification of the disability or disabilities by a State or local
governmental entity.
(2) Reports which state whether that individual is capable of engaging in
normal competitive employment. These reports shall be signed by a
person or persons qualified by training and experience to evaluate the
work potential, interests, aptitudes, and abilities of persons with disabilities
and shall normally consist of preadmission evaluations and reevaluations
prepared at least annually. The file on individuals who have been in the
nonprofit agency for less than two years shall contain the preadmission
report and, where appropriate, the next annual reevaluation. The file on
individuals who have been in the nonprofit agency for two or more years
shall contain, as a minimum, the reports of the two most recent annual
reevaluations.
As a result, to be eligible to count toward the direct labor ratio an individual must
have documentation in their file that not only states what the individual’s severe
disabilities are, but documents the extent of how the disabilities affect the
individual’s life functions. In addition, the file must contain an evaluation of the
individual’s ability to be employed competitively.
Normal Competitive Employment
The JWOD Act and regulations say that the individual must not be capable of
normal competitive employment, but does not actually define normal competitive
employment. The Committee has historically defined it as the ability of an
individual to find, obtain and maintain a non-JWOD job, with no supports from a
nonprofit. Commensurate wages would not be involved, because they are not a
part of normal employment. Put another way, the Committee considers an
individual to be capable of normal competitive employment if the individual can
do all of the following:

Is capable of working a full work week (40 hours),
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



Receives the same pay and benefits as any other worker performing
comparable work,
Only requires accommodations considered reasonable under ADA,
Can maintain a job for an extended period of time (months. if not years),
Can maintain a job without intervention from outside sources.
When the JWOD Act was passed in 1971 this concept may have been well
understood, but today in some states competitive employment has come to mean
any job that takes place in the community in an integrated setting, even if there
are job coaches or commensurate wages are paid. The Committee does not
view such jobs as being competitive, because they include accommodations that
most employers will not provide or involves a third party in making the job
successful.
Medical Documentation
The individual’s file must contain documentation; a clear statement as to what
condition or combination of conditions has resulted in an individual being
considered to be severely disabled. Such diagnostics must be determined by a
licensed professional capable of making that evaluation. For example:
Diagnosis
Mental Retardation
Licensed Professional
Psychologist
School Counselor
Report in File
Psychological Evaluation
Intellectual Report
Mental Illness
Psychiatrist or Clinical
Psychologist
Licensed MH Counselor
Psychiatric Evaluation
Medical Physician
Medical report
Physical Impairment
Diagnostic Summary
For some severe disabilities such as mental retardation and significant mental
illness, the diagnosis documentation almost always includes the extent of the
disability as part of the diagnosis. However, for most conditions whose severity
can exist on a continuum from mild to severe, a delineation of the degree of
impairment is required and frequently is not included as a normal part of the
diagnosis. In other words, a measure of the functional limitations must be known
in order to determine the degree of severity.
Depending on the disability, the age of the documentation may invalidate it, as
some disabling conditions can improve over time. As well, rehabilitative gains
may result in an individual becoming competitively employable. This is why
Committee regulations require that the competitive employability evaluations be
done initially and on an annual basis thereafter.
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For those who do not come from a referral agency such as VR, the self-referred
for example, it is often difficult to obtain adequate medical documentation.
Requests to those individuals to provide the documentation is usually not an
effective means of obtaining them. They either do not possess the
documentation, or can not explain to their doctor what the nonprofit requires.
The nonprofit should identify the individual’s point of primary medical care and
send the doctor or counselor a request containing a signed release from that
individual. The more specific the request, the better, particularly given the
necessity for knowing the extent of disabling aspects to medical diagnoses. An
explanation as to the purpose of the information can be critical; many physicians
routinely downplay the disabling aspects of medical conditions, so as to not harm
the employment of their patients. Thus is it important that they understand that
the JWOD program requires a person to have a bona fide severe disability in
order to qualify and that the extent of the disability must also be documented.
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Severely Disabled and not Competitively Employable Assessments
Minimum Acceptable Standards
Every year each nonprofit must certify to the Committee that there is a file
containing adequate evidence of a severe disability and an annual review for
competitive employability on each direct labor employee who is blind or has other
severe disabilities, including both JWOD and non-JWOD, verifying that the
individual meets the Committee's criteria per 41 CFR 51-4.3. It is therefore
critical that these assessments be done correctly as they are the basis of the
annual certification and are certifying each individual as severely disabled and
not competitively employable. It is also important to emphasize that they must be
done on all severely disabled individuals and not just those working on JWOD.
The minimum acceptable documentation would be a signed and dated written
narrative that synopsizes the individual’s disability or disabilities, indicates which
functional limitations are being affected and documents why the individual is not
competitively employable by indicating the accommodations and supports being
provided to the individual. This does not need to be an extensive document on
the individual being evaluated and in most cases need not be more than a single
page. This does not replace the need for the signed medical documentation to
be present in the file.
If a preprinted form is used it can not include a presumptive statement indicating
that the individual is not competitively employable. The simplest statement of
competitive employability is a question as to whether or not the individual is
currently capable of competitive employment with a yes or no selection and a
space for the reasons (accommodations and supports) why the individual is not
considered competitively employable. Undated statements, unsigned or no
reasons given would automatically be excluded as a valid non-competitive
employability evaluation.
Many nonprofits have other state and community requirements that they must
meet, such as annual Individual Evaluation Plans. The Committee has long held
that the Committee’s requirements can and should be made part of these
assessments. If done correctly there is no requirement for individual forms or
documentation just to meet the Committee’s requirements.
A form developed specifically to meet the JWOD requirements would contain the
following:
Synopsis of Severe disabilities – This section simply lists the individual’s
disabilities that the nonprofit believes are severe disabilities. It does not replace
the signed medical documentation. Rather it acts as a place to list multiple
disabilities to make it clearer for reviewers what are the individual’s disabilities.
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Synopsis of Extent of severe disabilities – This section serves as an area to
explain how the individual’s severe disabilities affect their life functions (self-care,
self-direction, work skills, work tolerance, communication or mobility). It does not
replace the requirement for the medical documentation to explain the extent of
the severe disability, rather it again allows the consolidation of the effects of
multiple disabilities in one place.
Competitively Employable – This is a simple yes or no to the question: “Is the
individual currently capable of competitive employment.”
Synopsis of Reasoning for noncompetitive employability – This is the nonprofit’s
reasoning for why they consider the individual to be not competitively employable
at this time. This section must provide details of the disability-related
accommodations and supports that are being employed and may contain
information on the goals that have been set for the individual for the next year.
Nonprofits may also utilize a check sheet to insure that many of the common
issues are considered when assessing an individual.
Evaluator Information – The name, title and signature of the evaluator and the
date of the evaluation.
Competitive Employment Evaluation
The concept of normal competitive employment or competitive employability in
the JWOD program is as fundamental as it is unique. The documented evidence
of a severe disability, the significant functional limitations resulting from it, and
the requirement for substantive workplace accommodations, forms the basis by
which a person’s non-competitive employability is established and justified.
However, a subparagraph of the regulations goes a bit further:
These reports shall be signed by a person or persons qualified by training
and experience to evaluate the work potential, interests, aptitudes, and
abilities of persons with disabilities and shall normally consist of
preadmission evaluations and reevaluations prepared at least annually.
The key point is that the nonprofit must have an evaluation program, with the
individual making the decision being one who is knowledgeable of people with
severe disabilities. While the individual’s direct supervisor has the best
understanding of how the individual is performing on the job, the supervisor
seldom has the background knowledge of severe disabilities required by the
regulations. Therefore, while the supervisor’s opinion should be a critical part of
the evaluation (particularly where it pertains to the implementation of
accommodations and the individual work performance), the evaluation should
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usually be completed by another individual, such as the rehabilitation director or
counselor at the nonprofit.
The Committee’s definition allows the evaluation process to be done by an entity
other than the nonprofit. However when this is done, the individual who makes
the evaluation, must meet the evaluator criteria noted above, and must base the
evaluation on all information available. In particular, the person making the
evaluation must be familiar with the individual’s work performance and the
accommodations and supports being provided by the nonprofit. For example, a
psychologist who conducts a psychological exam may believe that the individual
is not capable of competitive employment, but for this evaluation to be used for
the purpose of meeting the JWOD requirement it must be based on more than
just that exam. It must also take into account the individual’s actual work
performance at the nonprofit and the accommodations and supports being
provided there.
In addition to impairments directly related to a severe disability, some pertinent
indirect factors may affect competitiveness. For example, a consistent failure to
show up for work could be either a conduct issue, or a symptom of a
behavioral/emotional problem. It is essential that the difference be known, as
although both will negatively affect their employability, the former is not disability
related, while the latter is, and can be diagnosed and documented. Absenteeism
that is directly related to documented medical and psychological conditions,
should always be considered when evaluating an individual’s competitiveness.
Productivity may or may not support an individual being considered not
competitively employable. If it’s below 60%, it would clearly support an individual
being considered not competitively employable, given that the lower productivity
is disability related and not just a function of indolence or deportment.
Productivity levels above 75-80% are within the general range of competitively
employable people. On the other hand, just because a worker can perform work
at 100% does not necessarily mean that he or she is competitively employable.
The work may have been partitioned to allow the individual to work at a high
functioning rate, or the individual may have other disability related problems, for
which significant accommodations are still necessary.
Sometimes when a nonprofit take over commercial contracts it finds that some of
the existing workers have a severe disability and the nonprofit classifies them as
not competitively employable because they have a severe disability. In such
cases, a competitively employed individual is being declared not competitively
employable, simply because they now work for a new employer. In almost all
cases such an individual must be considered competitively employable. In a few
unusual cases where an individual was being supported or accommodated by
the commercial contractor to such an extent that they really weren’t competitively
employed, the nonprofit may consider this individual to be not competitively
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employable. However, when this is the case, such support requirements need to
be clearly documented.
People referred to nonprofits by state vocational rehabilitation services should
not be assumed automatically to be not competitively employable. While the vast
majority of referred individuals will qualify for the JWOD Program, VR’s
definitions and requirements differ from JWOD. As a result, some referrals may
not meet the JWOD definition of severely disabled and not competitively
employable. Nor should a VR determination that the individual is not
competitively employable be taken as meeting the Committee’s definition. A
referral from VR must therefore go through the same assessment process as
anyone else.
Finally, nonprofits on occasion use a determination of non-competitive
employability to justify classifying an individual as severely disabled, e.g. “the
disability must be severe, or he wouldn’t have been deemed not competitively
employable.” This logic should be reversed. The disability must be established
first, then its severity by ascertaining the extent of impairment, followed by a
determination of how this would or would not cause the person to be capable of
normal competitive employment.
Given the complexity of individual cases, where the disabilities, medical history
and job performance comprise the factors to be considered, the nonprofit
remains the appropriate entity to determine competitiveness. Still, the
Committee’s regulations call for an evaluation program. It is not sufficient for
nonprofits simply to assure that the annual evaluation statements are checked
off, signed, and put in the files. There needs to be evidence that a process
exists, one containing solid deductive logic. Training on the unique aspects of
JWOD requirements must be provided to all individuals who will be making such
assessments.
Initial Assessments
Although termed a preadmission evaluation, the Committee allows the nonprofit
30 days after the individual has begun work to complete the evaluation. This
allows the nonprofit to: make an appropriate job assignment, observe on-the-job
performance, and assess disability-related accommodation needs. Only with
this, will the nonprofit be able to make and document an informed determination
of a worker’s non-competitive employability.
When making an Initial determination that an individual can be counted as
severely disabled and not competitively employable, three questions need to
be answered, all in the affirmative:
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1. Does the individual have a physical or mental impairment, or a residual
limiting condition that is the result of an injury, disease, or birth defect?
If yes, confirm the presence of a diagnosis with supporting medical
documentation. This information should include measurability: its nature,
extent and degrees of functional limitation. A signature of a licensed
healthcare professional or certification of the disability by a governmental
agency must also be present.
2. Does the individual have any functional limitations in self-care, self-direction,
work skills, work tolerance, communication or mobility, as a direct result of the
aforementioned impairment(s)?
If yes, review the entire medical and personnel record relevant to the above
factors and work history. If the individual has been working during an
evaluative period, interview the supervisor and/or project manager for their
input in assessing accommodations and supports that are needed, due to the
individual’s impairments. Interview the individual, with regard to any functional
limitations they may have relating to a medical or psychological condition.
3. Are these functional limitations significant enough to cause the individual
currently to be unable to engage in normal competitive employment, over an
extended period of time?
To justify determinations of non-competitive employability, one should look
back to the above questions. Workers must have disabilities that produce
limitations that are significant enough to cause them to be not capable of
finding and maintaining work on their own. The determination must describe
this causal relationship.
Annual Assessments
This must be done on a yearly basis, preferably in the context of reviewing a
client’s “Individual Service plan,” or a worker’s annual evaluation. It is not a
rubber stamp that the individual continues to be severely disabled and not
competitively employable. The same basic process that was used for the initial
evaluation needs to be repeated. In addition to all of the basic factors that have
been thought through, two more need to be considered:
1. Has the disabling condition moderated, so that the limiting impairments no
longer predominate?
2. has the worker’s skills improved to the point where the disability is no longer
relevant as a result?
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The Committee’s definition of severe disabilities [41CFR51-1.3(2)] states: A
person with a severe mental or physical impairment, who is able to engage in
normal competitive employment, because the impairment has been overcome or
the condition has been substantially corrected is not “severely disabled” within
the meaning of the definition.
Many disabilities can improve with time or medical intervention and to review the
current state of the individual’s severe disability is a critical first step in the annual
assessment. It is also possible that with the training that the individual has
received during the past year that they may now be capable of competitive
employment. It is therefore important that the annual assessment indicates what
has and hasn’t changed from the last assessment.
An individual can change back and forth between being competitively employable
and not competitively employable. There is nothing in the JWOD regulations that
binds individuals to being competitively employable once they have been
classified as such. The key is to indicate what has changed.
Finally, the regulations indicate that the competitive employability assessment
needs to be done at least once a year. In the past some nonprofits have done
them semiannually or even quarterly. Nonprofits should consider their other
requirements and processes and integrate the Committee’s competitive
employment requirement where possible.
Examples of eligibility determinations
The following examples will provide some insight to the process that should be
used when conducting initial or annual assessments. The first example is a
general example of the process of determining what accommodations might
need to be made for an individual and the others are actual examples that the
Committee has seen.
FMS
The parameters for accommodating a physical disability, keeping in mind the jobspecific limitations that are caused by impairments, are a function of the
diagnosed disorder. This example will consider Fibromyalgia syndrome. FMS is
a condition with an elusive cause that like other debilitating conditions is manifest
on a broad spectrum with highly individualized symptoms. In its mildest form, as
commonly expressed, it is not a disability per se much less a severe one (it
would not compromise a person’s employment at this level). But in its worst
manifestations, its limitations could be quite significant, and as a result,
accommodation needs might be beyond what would be provided in normal work
settings. And for the JWOD program, this is of course critical.
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Generally, FMS is a complex, chronic condition which causes widespread pain
and fatigue in tendons, ligaments, muscles, and other soft tissue, as well as a
variety of other symptoms. Pain varies according to the time of day, weather,
sleep patterns, and stress level. People with FMS may also have sleep disorder,
irritable bowel syndrome, chronic headaches, skin and temperature sensitivity,
cognitive impairment, depression and anxiety, and irritable bladder.
How would a worker with FMS be accommodated? Firstly, individuals with FMS
may develop some of the limitations discussed below, but seldom develop all of
them. Also, the degree of limitation will vary widely, and this will directly effect
accommodation requirements. The following is only a sample of some of the
possibilities, as numerous other accommodation solutions may exist. Some
listed here are minor and might well be provided in normal employment, while
others not. Some depend on the extent of the modifications entailed.
Essential questions to consider first:
1. What limitations is the employee with this disorder experiencing?
2. How and to what extent do these limitations affect the employee’s job
performance?
3. What specific job tasks are problematic as a result of these limitations?
4. What accommodations are available to reduce or eliminate these problems?
5. Have all possible resources been used to determine possible
accommodations?
6. Has the employee been consulted regarding possible accommodations?
7. Once in place, has the effectiveness of these accommodations been
evaluated?
8. Are additional accommodations needed?
9. Is training needed for supervisors and other employees, with regard to this
specific disability?
Accommodation Ideas regarding FMS:
Concentration Issues:
• Provide written job instructions whenever possible or feasible
• Prioritize job assignments and provide more structure
• Allow for flexible work hours and a self-pace workload
• Allow periodic rest periods to reorient
• Provide memory aids, such as schedulers or organizers
• Minimize or remove distractions
• identify and reduce job stressors
Depression and Anxiety:
• Identify and reduce anxiety producers in the work environment
• Provide concise to-do lists and explicit written instructions
• Remind employee of important deadlines and performance requirements
• Allow time off for counseling
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• Provide clear expectations of responsibilities and consequences
• Provide sensitivity training to co-workers
• Allow additional breaks for stress management techniques
• Allow telephone calls during work hours to doctors and others for support
• identify antecedents and implement strategies for defusing untoward work
problems
• Provide information on counseling and employee assistance programs
Fatigue/Weakness:
• Reduce or eliminate the need for physical exertion in some measurable
amount
• Provide special light-weight equipment
• Schedule regular periodic rest breaks away from the workstation
• Allow a flexible work schedule and use of leave time
• Implement ergonomic workstation design
Fine Motor Impairment:
• Implement tailored ergonomic workstation design
• Provide alternative access to worksite equipment
• Provide arm supports
• Provide grip aids and other related assists
Gross Motor Impairment:
• Modify the work-site or its conditions to make it accessible
• Provide parking close to the work-site
• Provide transportation to the work site
• Provide an accessible entrance
• Install automatic door openers
• Provide an accessible restroom and break room
• Provide an accessible route of travel to other work areas
f• Revamp the workstation for maximum accessible
• Modify station height if wheelchair or scooter is used
Insure that essential materials and equipment are within reach
• Move workstation close to other work areas, equipment, and break rooms
Migraine Headaches:
• Provide tailored task lighting
• Eliminate fluorescent lighting
• Provide alternate work area to reduce visual and auditory distractions
• Implement a "fragrance-free" workplace policy
• Provide air purification devices
• Eliminate pulsing lights or sounds
• Allow flexible work hours
• Allow periodic rest breaks
• Reduce noise with sound absorbent baffles/partitions, environmental sound
machines, and headsets
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Skin Sensitivity:
• Avoid irritating agents and chemicals
• Provide protective clothing
Sleep Disorder:
• Allow flexible work hours
• Allow frequent breaks
Temperature Sensitivity:
• Modify work-site temperature: fan/air-conditioner or heater
• redirect vents and maintain ventilation system
• Allow flexible scheduling during extremely hot or cold weather
• Modify dress code
• Provide a work area with separate temperature control
Photosensitivity:
• Minimize outdoor activities between the peak hours of 10:00 am and 4:00 pm
• Avoid reflective surfaces such as sand, snow, and concrete
• Provide clothing to block UV rays
• Provide "waterproof" sun-protective agents such as sun blocks or sunscreens
• Install low wattage overhead lights
• Provide task lighting
• Replace fluorescent lighting with full spectrum or natural lighting
• Eliminate blinking and flickering lights
• Install adjustable window blinds and light filters
Learning disabled
A nonprofit had been employing an individual for several years and when hired
his disability was noted as dyslexia. During a correctly done annual review it was
found that he actually had been diagnosed in 1984 with Developmental Disorder,
NOS (with significant discrepancy between below average verbal capacities, and
average visual-spatial problem solving ability; as well as severe deficiencies in
reading, written expression, and mathematics). He also had a historical
diagnosis of Alcohol Dependency, in sustained full remission. Further review
found that he had spent three years on active duty in the Navy followed by
extensive service in the Air National Guard and Reserves, and that he had been
deployed overseas the year prior to this review.
Discussions with his lead supervisor revealed that he had no significant
impairments in occupational functioning and that he is an excellent worker who
requires minimal supervision and instruction. It was the supervisors feeling that
he does not demonstrate any behaviors, characteristics, or actions that indicate
he is severely disabled.
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Based on the supervisor’s comments and the fact that he had served on active
duty the previous year the nonprofit concluded that he was competitively
employable.
Amputee
Here are two cases of individuals with very similar amputations, but very different
determinations.
In the first case the individual involved was a 19 year old that recently lost her
right leg above the knee in a car accident. She had no prosthetic and moved
around using a wheelchair. Loss of a limb is a severe disability, but by itself does
not mean that individual was not competitively employable.
During the hiring process the nonprofit found her to have extremely low selfesteem and some psychological issues as result of the amputation. In addition
she had no previous work experience and did not present well in the job
interview. Based on the interview and the psychological issues the agency
considered her not competitively employable and placed her as a mail room clerk
on a small JWOD job.
This was a reasonable initial assessment. However, this case also shows the
need for annual reassessments. At the time of her first annual assessment the
nonprofit was so pleased with her performance that they no longer considered
her to be not competitively employable and promoted her to supervisor of the
project. Here is a good example of the individual overcoming her impairment.
In the second case a nonprofit received a referral from the state VR agency of an
individual whose leg had been amputated above the knee a number of years
ago. The VR referral also included the reasoning that the individual was not
competitively employable because he was a convicted felon and no one else
would hire him. The individual had worked at the nonprofit until he was jailed for
breaking probation and while working for the nonprofit previously did not require
any special accommodations or supports from the nonprofit.
While the Vocational Rehabilitation counselor may consider the individual not
competitively employable, this individual does not meet the Committee’s
definition of severely disabled and not competitively employable. While there can
be considerations other than the disability involved with making the determination
that the individual is not competitively employable, the core reasoning for the
decision must be based on the individual’s disability. In this case the individual’s
disability is not a factor as the nonprofit does not have to provide any supports.
The sole reason for considering the individual not competitively employable is
that he is a convicted felon just getting out of jail for breaking his parole.
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Highly Productive worker
As noted earlier an individual that is highly productive on a job is not necessarily
competitively employable. Here are two examples of cases where the nonprofit
found individuals whose productivity were more than 100 percent to be not
competitively employable.
In the first case the individual is responsible for cutting fabric and is mentally
retarded. From a performance standpoint he can run the cutting table faster than
anyone at the nonprofit, whether severely disabled or not. However, he has a
history of behavioral outbursts and is unpredictable as to whether or not he will
show up for work.
The second individual is also mentally retarded and works as a groundskeeper
mowing and trimming grass. His performance on the job is at about 120%. He
likes his job and unlike the first case has no behavioral or attendance issues.
Unfortunately, he requires close supervision since he has no concept of pacing
himself or how to remain hydrated in hot weather. In addition, he will work until
no more work is visible and will stop and wait for directions, or will simply
continue working in areas that were already finished or where the agency is not
responsible.
Return to not competitively employable status
The issue here is that an individual can move back and forth between being
competitively employable and not competitively employable. If a nonprofit
considers an individual to be competitively employable, it does not mean that he
can’t be reconsidered at a future date, if changes occur to the individual’s
disability status.
In this case an individual has mild mental retardation and worked as a mess
attendant on a JWOD food service contract. After working successfully for some
time, the agency determined that he was competitively employable. They
placed him with a local hotel busing tables and washing dishes. Initially very
pleased with his performance, the hotel gave him a raise, increased his hours
and began providing benefits. At this point he became overresourced and lost
his SSI benefits. His mother objected to this loss and harassied him to the point
that the stress affected his performance and the hotel eventually fired him. As a
result, the nonprofit rehired the individual and considers him to be not
competitively employable until they can again get him working at an acceptable
level.
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Substance Abuse
Five individuals were referred to a nonprofit for employment as part of a courtordered substance abuse rehabilitation program. This program included a
requirement that they live in a half-way house. As all five had experience with
seasonal grounds keeping, the nonprofit placed them on one of its grounds
maintenance projects as severely disabled and not competitively employable.
The Committee subsequently received a complaint from a commercial company
that the nonprofit was hiring non-disabled individuals. This complaint was based
on the owner’s observation that the five working for the nonprofit were not
disabled , all having worked for him in the past, and that one of the individuals
was trying to work for the commercial contractor and the nonprofit simultaneously
at the time. Further discussions with the contractor revealed that all five could
have had their old jobs back simply by applying for them, given that the
commercial contractor had been happy with their performance and was looking
for workers.
The Committee decided that four of the five individuals could continue to be
counted as not competitively employable, but only while they remained enrolled
in the drug rehabilitation program and lived in the half-way house. This decision
was based on additional documentation that the court had provided and that was
in their files; primarily the court’s requirement for close supervision while working.
The individual that was trying to work for both the commercial company and the
nonprofit was released by the nonprofit because of his continued use of illegal
drugs.
Worked for previous commercial contractor
Here are two examples of people with severe disabilities who had worked on the
previous commercial contract. One is competitively employable and the other is
not.
In the first case, when the nonprofit reviewed the current workforce, they found
that a number of people had what could be considered a severe disability.
Deciding that they wanted to count the individuals towards the 75 percent
requirement, the nonprofit went on to also declare the individual not competitively
employable. One of the individuals suffered from depression and was under a
doctor’s care and was taking several medications. However, even though the
individual was diagnosed with major depression her performance was excellent
and she had a good attendance record. Given this, the nonprofit did not need to
provide any accommodation or supports to the individual. They therefore could
not consider this individual to be not competitively employable.
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In the other case an individual worked for a commercial contractor as a medical
transcriptionist and telecommuted from home. The commercial contractor had
hired and trained the individual, but even after an extensive period of time, she
continued to fall short of the company’s minimum performance standards for
transcription rates and work hours. As a result, they had reached the point
where they were considering termination. In this case the nonprofit was able to
provide her with another position, documenting her severe disability. But, they
also documented that although she had been previously competitively employed,
her low work tolerance made her not competitively employable.
It is important to note that when an employee of a previous commercial
contractor is determined to be not competitively employable, the nonprofit must
be extremely careful to adequately document the reasoning for the
determination. In such cases, the previous contractor must have been providing
accommodations or supports that would be considered beyond reasonable.
Such accommodations would not typically be found in normal competitive job
situations.
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Discussion of Commonly seen Disabilities in the JWOD Program
Although mental retardation and significant mental illness predominate as the
majority of severe disabilities in the JWOD program, demographics reveal a
number of other disabilities to be quite prevalent. In this section, several such
disabilities are specifically mentioned as examples. Although psychological,
physical and medical conditions are dissimilar, they require the same kind of
assessment in terms of understanding the degree of impairment, and exercise of
informed judgment in determining non-competitive employability.
Learning disability - General
Learning disabilities come in a variety of forms and tend to be characterized
more as barriers to educational and academic learning, than obstacles to the
kind of performance-based training that is seen in the JWOD program. As well,
learning disabilities range widely in the degree of their manifestation. Some
individuals only have dyslexia, but are above average in intelligence, while others
have more pervasive problems that put them in the low seventies to eighty IQ
range. In the latter cases, they would certainly have a more difficult time finding
work, given their narrowed options, but for the most part, one cannot claim that
they are unequivocally not competitively employable on that basis alone. This is
due to the fact that they don’t fit the criteria previously specified in 41CFR51-1.3,
“…which so limits the person's functional capabilities (mobility, communication,
self-care, self-direction, work tolerance.” The majority of individuals in our
society, who are in this range, are competitively employed. However, as stated
above, additional debilitating issues could and would likely change this, and in
cases of marked or pervasive learning disabilities, it would not take much to
compromise their employability, on the basis of an aggregate of disabling factors.
The Committee has also seen cases where people are classified as learning
disable that actually could be classified as having a different disability. The
individual doing the classification sees the other disability as more severe and
doesn’t want to place a stigma on the person being classified. Specifically we
have seen documentation from school systems that classify people with mentally
retardation as learning disabled.
In short, learning disabilities can be considerd severe, if additional
documentation supporting one or more other disabling conditions is present, and
the overall impairments when taken together, would cause an individual to be not
competitively employable.
Attention Deficit Disorder (ADD)
This is not by itself a severe disability. However in its severest form, with
significant hyper activity (ADDH) as the salient issue, other relevant
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psychological problems may be misattributed to it, certainly as it is manifest in
adults. Other diagnosable conditions if present must be documented.
As ADD is typically not so pervasively debilitating, additional disability issues are
required to certify the person as severely disabled. And if combined with other
learning disabilities, some degree of significance needs to be documented, in
order to understand how it causes the individual to be not competitively
employable. Due to so many individuals with ADD or ADDH diagnoses having
quite high intelligence, the nonprofit needs to document what disability-related
accommodations are required to keep this individual employed.
Illiteracy
The inability to read would definitely have an adverse impact on a person’s job
prospects, but without any causal cognitive indicators inherent in the individual
and noted as an Axis II diagnosis, it must be seen as purely an educational
deficit (“disadvantaged” being a common alternative term) and cannot be
considered a disability, much less a severe one.
At present, most illiteracy that is encountered, falls into the category of English
illiteracy, or an inability to read and write in English beyond the primary school
level. Recent immigrants who may have had limited educational opportunity in
their native countries comprise most of this group. Sociological factors that
exacerbate employability are not disabilities.
Dyslexia
This disorder is similar but less adverse than illiteracy, because those who
experience it can actually read, albeit with varying degrees of difficulty. It is
termed a disability because of its symptoms of visual or cognitive misperception,
but is minor in light of global life functioning. Like ADD, many persons of high
intelligence and achievement have this disorder. However, to reiterate, even
when severe, dyslexia is only an impediment to reading, which alone is
insufficient to make someone not competitively employable. It is also germane
that the overwhelming majority of jobs within the JWOD program do not require
reading beyond a rudimentary level, if at all.
Mental Illness
Axis I diagnoses such as schizophrenia and bipolar disorders that have psychotic
components are commonly considered “severe,” because even when responsive
to treatment, they remain pervasively disabling. As a class, such individuals are
consistent with 41CFR51-1.3 and the extent of the disability will be obvious from
the diagnosis. Accommodations for them are normally a straightforward matter
given the substantial nature of what is required.
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Other disorders with similar psychotic characteristics should also be seen as
severe disabilities, schizoaffective and Schizophreniform Disorders for example.
These significant mental illnesses are typically severe enough to bring about
non-competitive employability in an overwhelming number of those with the
diagnosis. As above, determining competitive employability is a function of
enumerating the significant accommodations that must typically be provided.
Affective or mood disorders
Those such as: Major Depressive Disorder, Dysthymic Disorder, and both Bipolar
I and II Disorder are significant enough in their manifestations to warrant a
presumption of severe disability. Similarly, Cyclothymic Disorder in most cases
can be considered as such.
Singular diagnoses of Depression or Anxiety are different, because they fall on a
continuum. At the most severe end, their manifestations would render a person
not competitively employable, In the case of depression for example, it would
constitute major depression with associated physical symptoms. However, in its
mildest forms, most who are depressed at this level, are competitively employed.
The effectiveness of medications in such disorders is highly relevant. On
occasion, the only measures of workers’ depressive limitations are the notations
of prescribed medication. However, there should be documentation of
depressive behavior, beyond that which the medication has controlled, for in the
absence of such, the individual would be not impaired. Absenteeism is quite
germane to people who have depression, but it must be recorded and be at a
level well beyond what non disabled workers experience.
With the various forms of anxiety: Generalized, Panic, Social, Phobias,
Obsessive-Compulsive and PTSD; the degree of impairment must be
ascertained, just as it needs to be with a diagnosis of depression.
Medical documentation in these areas must indicate the parameters of a
diagnosis to be understood in disability terms. As such, affective or mood
disorders will typically include
• Clinical symptoms such as depressed mood and feelings of worthlessness or
guilt., apprehension fear, or even terror.
• Behavioral symptoms might include social withdrawal or agitation.
• Cognitive symptoms, or problems in thinking include difficulty with
concentration or making decisions.
• Somatic or physical symptoms can include insomnia, hypersomnia,
migraines , loss or gain of weight, and alimentary digestive problems.
With knowledge of the above, one can proceed by answering the following
question: How disabling is this condition? What are its impairments? To what
extent does it limit the individual? As such, any description in the psychological
evaluation that describes intensity, frequency and duration of episodes can
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give one a good sense of this. What aspect of this worker’s disability is limiting
his or her productivity? And how much? What accommodations or supports
are required because of it?
These issues are essential in both verifying the severity of the workers’ disability,
and its capacity to bring about a loss of competitiveness. But they are just as
important in order to better support the worker’s productivity.
As for Personality Disorders, there are 11: Paranoid, Schizoid, Schizo Typal,
Anti-social, Borderline, Histrionic, Narcissistic, Avoidant, Dependant, ObsessiveCompulsive and Personality Disorder NOS.
Although there is some variation as to their impact in a job setting, each one of
these diagnoses should be considered to be a severe disability, because any
given individual having been so diagnosed, would (unless otherwise indicated)
be sufficiently affected by it, to be not competitively employable. Most will have
found competitive work in the past, but given the serious nature and
pervasiveness of a personality disorder, their work histories will usually show that
they have been markedly unsuccessful in maintaining such work.
Other mental disorders
Many exist, with some being inherently severe while others may or may not be:
cognitive disorders, somatoform Disorders, dissociative Disorders and ImpulseControl Disorders are typically severe enough to bring about a loss of
competitiveness. But there are no substitutes for definitive medical
documentation that is consistent with a solid competitive employment evaluation.
Physical Disabilities
Presented below are several commonly seen conditions, which require
assessments of extent and degree of impairment, in order to understand the
limitation of functioning. If severity is to be ascertained, a measure of how it
impacts a person’s ability to find and maintain work, must be established.
Amputation
The loss of a limb, or part of one, may or may not be considered severe, based
similarly to the criteria of other disabling conditions, on the extent of functional
impairment. And as in other disabilities, there can be a range. In most cases,
loss of a hand would be a severe disability, particularly if a dominant hand has
been lost, and involving a persons who is only capable of manual work.
However, the loss of a finger or fingers requires much more scrutiny. Each
individual must be assessed as to accommodations required and loss of
productivity attributable to the amputation, measured.
The salience of the amputation must also be considered: from loss of an arm
above the elbow, or below; loss of hand, to loss of fingers to partial loss of
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fingers, to the loss of a single finger. The inherent adaptability or lack of it in
each individual is very relevant in an evaluation, and past work history can be
helpful here. Also pertinent is any adverse synergy from other physical or
psychological conditions. However if present, they must be separately
diagnosed and documented.
In the wake of recent-day prosthetic developments, especially in cases of belowthe-knee amputations, a well-functioning prosthetic can reduce the limiting
impairment to a near unnoticeable level. As a result, a slight residual limp would
not be considered a severe disability, but an inability to stand and walk around
for most of a shift (in the case of a janitor say), may well result in a person losing
their competitiveness. In terms of other common limits, an overall loss of
productivity may be seen as a result of the individual working around his
limitation, i.e. inefficiencies in stooping bending and kneeling; lessened ability to
push and pull equipment; and reduced speed generally. All such limits need to
be measured against an established standard, if for no other reason than to
understand the extent of the amputation’s disablement. More effective,
appropriate and disability-centered accommodations will surely follow.
Nonprofits need to consider the whole person in such a determination, and how
related factors, in aggregate, might or might not lead to their being determined
not competitively employable. What residual disabling effects are a direct results
of the amputation? Was the individual referred to the nonprofit at the vocational
end of their post amputation rehabilitation? Or, had they been working
competitively for some years subsequent to it? What accommodations must be
provided in relation to the worker’s amputation? The answers to such questions
are fundamental to the competitive evaluation.
Arthritis
This condition is frequently presented, by virtue of the medical documentation,
with only vague descriptions of its disabling effects. At one end of a continuum,
arthritis can generate occasional mild pain in one or more joints. However, at the
extreme other end, severe arthritis, and certainly rheumatoid arthritis, can lead to
near total incapacity. In order to gain any reckoning of severity, one must be
able to understand where the person is on this spectrum. As always, it begins
with a definitive diagnosis; is it osteoarthritis or osteoporosis et cetera?
Measurability of its extent then becomes the next step. If walking is affected,
how much so? What are the actual restrictions to walking? Standing?
Stooping? Other areas such as arthritis in the spine or shoulders will affect a
person’s ability to stand for periods of time, or to reach. How long or how often
can they do such tasks? Quantified pain is also relevant: is it constant or
episodic? How long to typical episodes last? How intense is it? So intense that
it results in loss of work time? The question of which medications are being
taken and how they have served to ameliorate the symptoms also needs to be
answered. Given such wide variability in this disease, from one individual to
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another, nothing can be presumed. It is therefore essential that the fullest extent
of its disabling effects be shown.
Deafness
Although the measurement or threshold for blindness has long been codified in
law (legal blindness), the same is not so for deafness. Many individuals are cited
in their medical documentation as being “hearing impaired,” which only indicates
that there is a loss of hearing along some gradient. This obviously covers a wide
range. In such cases, the first question should always be, how impaired? Other
vague references such as “hearing loss” generate the similar question, how
much?
Quite often though, audiological reports can be arcane, but familiarization with
them can aid in justifying a determination, to say nothing of making more
appropriate accommodations. Certainly however, anyone who is deaf enough
that they cannot hear the spoken word, under normal conditions, should be
considered severely disabled. If the hearing loss is to the degree that it has
caused significant speech impairment, this would be a relevant and ADDITIVE, if
not determinative indicator of severity. However, if a person can hear, even with
the use of hearing aids, and can communicate adequately, the functional
impairment caused by the deficit, must be seen as quite a bit less. Such a
limited loss would still be a disability, but not a severe one. The person might still
be seen as not competitively employable, but would require additional disabling
conditions to justify that significant impairments exist.
As a further guide, consider the portion of the Helen Keller National Center Act
definition of deaf-blind that deals with deafness:
“…who has a chronic hearing impairment so severe that most speech
cannot be understood with optimum amplification, or a progressive
hearing loss having a prognosis leading to this condition.”
Diabetes
This is first a medical condition, not necessarily a de facto severe disability.
However in its graver manifestations, it can produce a number of highly
debilitating symptoms (up to and including death): blindness, impairments to
cardiac functioning and vascular degeneration and neuropathy in the extremities,
particularly legs and feet. Kidney problems are also often associated with
Diabetes, and all such debilitating issues and their degree of impairment should
be specified. If not documented, they do not exist.
Epilepsy and Seizure Disorders
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Epilepsy is not a distinct disease, but rather a group of disorders for which
recurrent unprovoked seizures are the main symptom. Such seizures are
brought about by abnormal electrical discharges from brain cells, often in the
cerebral cortex, either secondary to a particular brain abnormality, or of unknown
etiology. There are several types of seizures and for the purposes of the JWOD
program it is their effect on a given individual’s employability that is critical. A
number of anticonvulsant medications are effective in controlling seizures, from
complete elimination to reducing their frequency.
For those diagnosed with a seizure disorder, there are essentially three
questions to be answered: 1. Are they taking medication for the disorder? 2.
Has this treatment eliminated or just reduced the frequency of seizures? 3. If
only a reduction has been achieved and seizures still occur (when the disorder is
termed “medically
Refractory”); what is the frequency and type?
There are several types of seizures, but that which is most relevant to the JWOD
program (as is true of medical conditions generally) occurs when the disorder is
such that it compromises a person’s competitive employability. Unless otherwise
indicated, Tonic-clonic seizures (sometimes referred to as grand mal seizures)
are the type which reliably causes a loss of competitiveness. Other types of
seizures with less severe manifestations and less frequent occurrences have the
potential for causing non-competitive employability, but they cannot routinely be
presumed to do so. They would need to be characterized by their effects,
wherein significant job accommodations would be required for issues related to
the seizure disorder.
If seizures are fully controlled by medication and the individual is functioning
within the normal range, then the individual should be considered competitively
employable. Howver, if a worker has a seizure disorder and has been seizure
free for an extended period of time, but is still felt to be not competitively
employable due to the effects of the medication that is being used that should be
documented.
A marked and measurable decline in cognitive function is known to correlate with
many cases of epilepsy (although it has not been definitively established as to
what extent this is due to the epilepsy itself or to the drugs used to treat it).
However, if a cognitive deficit is present, it should not necessarily be seen as an
inherent symptom of epilepsy, and should be a separate Axis 2 diagnosis.
Hypertension
High blood pressure may or may not have inherent physically disabling issues, it
can exist by itself, in varying measurable degrees of severity, or it may itself be a
symptom of some more serious cardio-vascular condition, with still other parallel
symptoms being present. Nonetheless, whatever is present must be noted, with
26
some indication as to the degree of physical limitation and impairment produced
by it.
Many individuals, who have mild to moderate high blood pressure that is
responding to medication, will incur little debilitating effects. As such,
documentation should specify how the person is responding to treatment, or what
physical restrictions continue to exist in spite of such treatment. What major job
accommodations are being provided because of it?
Multiple - Disabilities of a Less Than Severe Nature
Quite often, individuals have two or more diagnosed conditions, which by
themselves are not severe disabilities. However, if the total impairment to the
individual is sufficient to reasonably cause a loss of competitiveness, then they
can be accepted as severely disabled. And as in all the disabilities mentioned, a
sound determination is always a function of how well the degree of impairment
can be ascertained. The more adequate the medical documentation and the
workplace evaluations, the sounder the justification. It is a fact however that
many medical records are the result of treatment interventions. With such,
diagnoses and prescribed treatments are typically the only indications specified.
The existence of disabling effects may be missing. To meet JWOD program
requirements, most medical conditions need to be seen in both qualitative and
quantitative terms. Without it, measurability and hence severity can be
impossible to ascertain. If it cannot be determined from the documentation
present, the individual cannot be counted toward the agency’s severely disabled
ratio.
Referencing another example; if a person’s record indicates that they have some
arthritis in their knees, and diabetes requiring insulin injections, with no other
details, additional information would be needed to establish the degree in which
these conditions are manifest. Work assessment can contribute substantially
here, insomuch as the individual’s ability or inability to stand and walk about
through the workday is pertinent. However all the potential ancillary medical
issues related to diabetes can offer some reckoning of an incremental adverse
impact on employability. Heart insufficiency, obesity, renal issues etc. all can
impact a person’s ability to hold a competitive job, by causing the person to have
frequent absences, if that is the case. Such conditions are all about limitations;
what are they and how much do they limit? Whatever the case however, the
JWOD program requires that they be documented in order to be seen to exist.
The issue of absenteeism was incorporated into the JWOD program from the
outset, in its being measured in hours rather than simply jobs. Nonprofits
participating in the JWOD program routinely provide accommodation to
significantly higher levels of “lost work,” than does the competitive workplace.
Limited work tolerance directly related to the full range of disabilities is the major
contributor to this.
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In assessing a person’s capacity to hold a competitive job, a best judgment
ultimately has to be made. Unfortunately, the medical issues and mental
limitations presented, do not come with numeric values to be simply added up.
In the end, it might be distilled to; how reasonable was the judgment? Would a
reasonable observer, albeit one knowledgeable of such criteria, see this person
as being severely disabled, to the point that they would be unable to find and
maintain a normal competitive job on their own?
When the judgment is not so reasonable, it tends to occur when the disabling
condition at issue hasn’t been thought through in the manner described in this
paper. Instead, an outside reviewer might find justifications such as:
• State DVR referral accepted without a clear diagnosis
• Poor work history equated with non-competitive employability
• Social disadvantages used as disability intensifiers.
Obesity
In assessing whether or not obesity is a severe disability, the term “morbid
obesity” should be used as a benchmark. At this level, physical restrictions
become so significant as to compromise employability in the vast majority of
cases, and wherein mere obesity alone would not.
Morbid obesity refers to individuals who have a body mass index) (BMI) value of
40 or more (an arbitrary but reasonable threshold for presumption). Alternative
measurements that begin much lower, such as 50% above or 100 lbs. above
“ideal body weight,” may be medically relevant, but generally do not ordinarily
produce enough impairment of functioning to presume a severe disability.
It is important to note that morbid obesity has a number of medical conditions
that are highly correlated with it: diabetes, hypertension, heart disease, stroke,
depression, osteoarthritis, hypoxemia and certain psychological disorders. Each
of these conditions should be documented when present, with the extent of their
debilitating effects noted.
Alcohol, Drug addiction and other substance abuse
Prior to 1992 the Committee did not accept alcohol or drug addiction as a severe
disability under the JWOD Program. In September 1992, the Committee
reviewed this decision and stated decided that although:
“…The legislative history is silent on this subject… The Committee has no
legal basis for excluding from eligibility for JWOD benefits recovering
alcoholics and drug abusers who meet the employment criterion.”
And,
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“…to permit recovering alcoholics and drug abusers (with appropriate
documentation of their disorders) to be counted as "other severely
handicapped" if they meet the employment criterion.”
However the Committee went further:
“On the other hand, based on the same legislative history, operating history, and
Congressional and Executive Branch hearings and correspondence, it seems
eminently reasonable to conclude that individuals with these disabilities were not
intended to be the primary--or even a substantial portion of the--target population
of the JWOD Program. As a result, the Committee also has a responsibility to
guard against a significant shift toward using the JWOD Program to serve
recovering alcoholics and drug abusers.”
“..who meet the employment criterion.” Again, this remains a central point.
However, how one satisfies that criterion, appears to be where the difficulties
arise. Substance Abuse must be seen in terms of how it’s disabling in each
specific case, and its impact on each individual’s ability or inability to find and
maintain competitive employment, at the present time. The impairments that
brought about a loss of competitiveness, which were a direct result of a clinical
addiction (an operative term when considering severity), must be shown.
To justify a severe disability on the basis of substance abuse, there needs to be
a medical diagnosis of fairly recent addiction (a severity indicator), and as a
direct result of this, some form of ongoing therapeutic involvement. Without this,
the record might only contain notations of some unspecified history of an
individual’s use/abuse of a controlled substance. Excluding issues of conduct
and unemployability, such occasional indulgence likely would not result in true
non-competitive employability, and even less so with the passage of time, given
rehabilitative efforts and sustained abstinence.
References in the record to unquantified “usage” in some vague past timeframe
is quite inadequate because it may have little or no bearing on the person’s
present employability. In the medical documentation, terms such as “former
substance abuser” is problematic, i.e. how long has it been? Did they indulge in
drugs way back in the sixties? More recently? What drugs? When and how so?
For how long a period? To what extent? In the absence of these questions
being documented, all we would really have is an able-bodied individual, who is
otherwise not cognitively impaired, being counted as a severely disabled worker.
In other words, the mere notation of a person having a substance abuse history
is not a self-evident cause for considering the individual to be severely disabled
or non-competitive employable.
In completing a medical history, patients sometimes tell their physicians that
they’ve used illicit substances. Such disclosures will invariably be noted in their
records, albeit with ambiguous terms such as “history of substance abuse.” They
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may also report overindulgence in alcohol, which will also be documented as
medically relevant. However neither may be in any way significant enough to
cause the person to be severely disabled or not competitively employable. And if
it was ever so, it may not be at present.
When gauging the severity of substance abuse, the establishment of its
parameters is similar to that of other disability conditions previously described. In
this, it must be shown to directly bring about a loss of competitive employment,
“…over an extended period of time.”
Evaluation frequency
The Committee has stated that recovering addicts and alcoholics can participate
in the program. However, the Committee does not accept the idea that in terms
of competitive employment that an individual is recovering forever, and hence will
always be automatically not competitively employable. The Committee
presumes that after a period of time and rehabilitative effort, these individuals will
become competitively employable, unless documented with clinical interventions
that indicate otherwise.
The Committee has for a number of years, considered a period of one to two
years to be a cut-off for non-competitiveness, for an individual whose sole
documented disability is alcohol or drug addiction. Such a line is admittedly
arbitrary, but this can be amendable to a rehab professionals’ judgment, given
additional complicating addiction-related factors that may persist in any
individual’s case, and provided they are documented in a manner whereby said
factors can be seen to cause continued non-competitive employability.
Diagnoses of “use” and “abuse” of substances should not expect the same
presumptions because they are separate, lesser severe diagnoses, than that of
“dependency,” and with much less profound long-term treatment ramifications.
Such distinctions relate directly to their capacity or lack of it, to affect an
individuals being capable of engaging in normal competitive employment.
Put another way, and given a straight-forward case, with no complicating factors,
one year beyond starting work at the nonprofit, would seem to be a reasonable
maximum. At some point, it must be acknowledged as to when each individual is
drug free, relatively addiction resistant, mentally competent and physically able.
To state it again, if the period is to be extended, it must be justifiable, by the
worker’s continued non-competitive employability, and for the strong addictionrelated reasons causing it. The commonly applied adjective “recovering” is not
an operative justification for this, given its implication that recovery is perpetual.
Such is a misnomer in the sense that it is not actually recovery that is perpetual,
but rather the continuing and persistent need for abstinence and sobriety. And
by extension, this also does not mean that lifelong rehabilitation is needed,
whereby competitive employment has been indefinitely compromised.
Active vs. Passive Programs
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The Committee has for some time also required an “active rehabilitation”
component to be in evidence. Active programs involve structured therapeutic
interventions, the kind provided by half-way houses for example, or
psychotherapeutic or medical treatment delivered by facilities with this specific
mission.
Such requirements serve two purposes; one, such persons typically are not very
employable in the general economy, while living in a treatment half-way house or
the like; and two, such persons by definition tend to be in the earlier phase of
their rehabilitation, and thus are at a much more vulnerable stage, recidivism
being at a high rate among them. These two factors constitute the reason such
persons are considered temporarily severely disabled and not competitively
employable.
Although it has long served many individuals as a means of their maintaining
sobriety and abstinence, participation in Alcoholics Anonymous or AA is not a
useful means of determining or verifying an individual’s ongoing status of noncompetitive employability due to substance abuse.
Although highly regarded for its effectiveness, AA is a passive program, allowing
its members to come as frequently or as infrequently as they desire, and to
participate or not as they may wish. It is a self-help maintenance group, not a
professional organization or agency providing early-on alcohol and substance
abuse rehabilitation. Certainly, attendance at its meetings has little direct
relationship to a person’s non-competitive employability. Some who attend AA
only attend occasionally, while engaging in frequent bouts of alcohol use inbetween. Many others attend AA regularly, years after they’ve successfully quit
all abuse. Some are employed, some are not. As a result of such wide
variability, nonprofit staffs need to be able to make such distinctions, and that is
why they need relevant feedback from formalized organizations, and which AA
cannot provide. Verification of a present severe condition is the key here.
Coexisting Disability Issues
Any disabling conditions (of any measurable degree) that exist simultaneously
with post Alcohol and drug addiction which are documented, should be given
weight as complicating factors. However, this weight should always be
proportional to their degree of severity in producing additional measurable
degrees of impairment. If a person remains uncompetitive, due to a coexisting
condition typically psychiatric or psychological, it needs to be diagnosed and
documented by an appropriate licensed professional. It should not be
misattributed or understood to be a self-evident function or symptom of
substance abuse.
On the other hand, Substance-Induced mental Disorders may be present and
cause a variety of symptoms that are characteristic of other mental disorders.
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When existing, they will have an adverse effect on competitive employability, but
as they are neither inherent nor self-evident they require a differential diagnosis.
Verification
The provision of documentation verifying treatment, is a mutual and consensual
arrangement between the employee and the nonprofit, wherein as part of the
terms of employment, the worker agrees to allow their employer to obtain (by
signing a release of information) a verification of their source of, and continuance
in alcohol or drug treatment. This is generally true for all categories of disability,
not just alcohol/and drug dependency, and may seem slightly more intrusive
here, due to its stigma and need for more frequent assurance. It is important to
understand however, that in the context of the JWOD program, such a disclosure
does not close the door to employment (as it may elsewhere), but rather opens it.
Again, as in all categories, a person must have a severe disability to participate
in the JWOD program, and the nonprofit must have some means of verifying that
such a disability exists, and continues to exist. Verification that a worker is
participating in an active alcohol/drug rehab program is therefore not
unreasonable. However, verification can hardly occur without a valid means of
verification.
Veterans Affairs (VA) Disability Ratings (all conditions)
VA ratings of disability are specified in percentages, Fractions of 100 percent, at
which total disablement is implied. The problem is, these percentages of
“disability” do not necessarily measure degrees of disability. Rather, they are
simply adjudicated levels of a “compensable medical condition.” These
conditions may or may not have a functional disability component, irrespective of
percentage. Although a rating of “100% disabled” would in most cases result in a
person being considered severe, it is not necessarily so, and it is usually very far
from the total incapacity implied by 100 percent. Conversely, perceptions of total
disablement at 100 percent, often cause fractional amounts to appear as
approximations of this same whole. As a result, a worker with a 40% rating for
example, is commonly seen as being only able to function at 60% of a nondisabled worker’s level. Determinations of severely disabled and not
competitively employable then follow. However, the worker’s demonstrated
productivity and negligible need for accommodation typically tell a different story.
VA rating certificates that serve to document a workers’ claim to a severe
disability do not always even give a diagnosis. Sometimes only an anatomical
location is mentioned, such as “Left knee 20%.” Very rarely is there a rendering
as to the actual extent of disablement, the rating percentage operating as a kind
of substitute. But as stated above, ratings percentages are not a reliable
measure of functional disability. Useful clinical descriptions and measures of
impairment may exist in the VA medical record, but through their adjudication
process said quantifications are converted into the ratings noted. Whatever
32
percentage assigned however, actual degrees of impairment and description of
functional limitation are indispensable when trying to determine whether a person
is not competitively employable. Hence VA percentages by themselves, do not
constitute adequate documentation of a severe disability for the JWOD Program.
33
FREQUENTLY ASKED QUESTIONS
1. WHAT QUALIFIES A NON-PROFIT AGENCY TO PARTICIPATE IN THE
JWOD PROGRAM?
In order to participate in the JWOD Program a nonprofit must be verified by the
Committee as a
2. HOW DOES JWOD DEFINE A SEVERELY DISABLED INDIVIDUAL?
The Committee’s regulations (41CFR51) define severely disabled as:
Other severely handicapped and severely handicapped individuals (hereinafter
persons with severe disabilities) mean a person other than a blind person who
has a severe physical or mental impairment (a residual, limiting condition
resulting from an injury, disease, or congenital defect) which so limits the
person's functional capabilities (mobility, communication, self-care, self-direction,
work tolerance or work skills) that the individual is unable to engage in normal
competitive employment over an extended period of time.
(1) Capability for normal competitive employment shall be determined from
information developed by an ongoing evaluation program conducted by or for the
nonprofit agency and shall include as a minimum, a preadmission evaluation and
a reevaluation at least annually of each individual's capability for normal
competitive employment.
(2) A person with a severe mental or physical impairment who is able to engage
in normal competitive employment because the impairment has been overcome
or the condition has been substantially corrected is not "other severely
handicapped" within the meaning of the definition.
3. WHAT KIND OF DOCUMENTS ARE REQUIRED SO THAT A NON-PROFIT
AGENCY CAN CERTIFY SOMEONE AS BEING "SEVERELY DISABLED"?
A written report signed by a licensed physician, psychiatrist, or qualified
psychologist, reflecting the nature and extent of the disability or disabilities that
cause such person to qualify as a person with a severe disability, or a
certification of the disability or disabilities by a State or local governmental entity.
A key point frequently missed when reviewing this statement is that the
documentation must provide information on the extent of the disability.
4. WHAT DOES JWOD MEAN WHEN IT USES THE TERM, "NORMAL
34
COMPETITIVE EMPLOYMENT"?
The Committee has historically defined it as the ability of an individual to find,
obtain and maintain a non-JWOD job, with no supports from a nonprofit.
Commensurate wages would not be involved, because they are not a part of
normal employment. Put another way, the Committee considers an individual to
be capable of normal competitive employment if the individual can do all of the
following:





Is capable of working a full work week (40 hours),
Receives the same pay and benefits as any other worker performing
comparable work,
Only requires accommodations considered reasonable under ADA,
Can maintain a job for an extended period of time (months. if not years),
Can maintain a job without intervention from outside sources.
5. WHAT KIND OF DOCUMENTATION IS REQUIRED IN ORDER TO HELP
DETERMINE IF A PERSON IS NOT COMPETITIVELY EMPLOYABLE?
The nonprofit needs to be able to document that it is providing the individual with
accommodations and supports that would not be considered reasonable by most
employers. Information on the individual’s productivity, level of supervision
required, work tolerance and disruptive behavioral issues are common examples.
6. WHY DOES JWOD REQUIRE A "COMPETITIVE EMPLOYMENT"
EVALUATION?
The evaluation is done to insure that the JWOD Program is serving those people
that it was intended to serve. The language of the JWOD act specifies that to be
counted towards the 75% direct labor ratio an individual must be severely
disabled and not competitively employable. Just because an individual has a
severe disability it does not mean that they are competitively unemployable. In
addition because people are capable of overcoming their disabilities, the
assessment that an individual is not competitively employable must be reviewed
annual to insure that it is still correct.
7. HOW IS THE COMPETITIVE EMPLOYMENT EVALUATION CONDUCTED?
The nonprofit must have an evaluation program, with the individual making the
decision being one who is knowledgeable of people with severe disabilities.
While the individual’s direct supervisor has the best understanding of how the
individual is performing on the job, the supervisor seldom has the background
knowledge of severe disabilities required by the regulations. Therefore, while the
supervisor’s opinion should be a critical part of the evaluation (particularly where
35
it pertains to the implementation of accommodations and the individual work
performance), the evaluation should usually be completed by another individual,
such as the rehabilitation director or counselor at the nonprofit.
8. WHAT IS AN "INITIAL ASSESSMENT"?
The initial assessment is the first evaluation by the nonprofit agency that an
individual being considered to be counted towards the 75% direct labor ratio is in
fact severely disabled and not competitively employable. It should be completed
after the individual has been at the nonprofit long enough to adequately
determine what accommodations and supports are required, but after no more
than 30 days.
9. WHAT IS AN "ANNUAL ASSESSMENT?
The annual assessment is the yearly evaluation by the nonprofit agency that an
individual being counted towards the 75% direct labor ratio is still severely
disabled and not competitively employable.
10. WHAT ARE THE COMMONLY SEEN DISABILITIES IN THE JWOD
PROGRAM?
A demographic survey conducted by NISH in 2005 found the following
distribution
Mental retardation
Mental Illness
Physical Disabilities
Developmental disabilities
Deafness/Hearing impairment
Substance Abuse/Alcoholism
Neurological/Epilepsy
37%
21%
13%
9%
4%
4%
3%
Note: these were provide by NISH as preliminary results we need to check
before we go final on this guide
11. CAN YOU SHOW ME SOME EXAMPLES OF ACCEPTABLE MEDICAL,
ASSESSMENT, AND EVALUATIVE DOCUMENTATION?
See the Examples of Acceptable Evaluations section of this guide; which begins
on page XXX.
36
Glossary
Accommodation – In normal employment settings, employers are obligated to
provide “reasonable” accommodations to all workers under the Americans with
Disabilities Act (ADA), though whether some particular accommodation is
reasonable or unreasonable, has often been the subject of litigation. Still, when
there is a consensus that it is not reasonable, or an unfair burden on an
employer, such an accommodation will hardly ever be found in normal
competitive employment. On the other hand, extensive job supports are routinely
found in nonprofits participating in the JWOD program.
Commensurate wages – Also frequently referred to as subminimum wages.
Commensurate wages are wages that are commensurate with, and tied to, a
worker’s productivity. The authority to pay commensurate wages is contained in
the Fair labor Standards Act in Section 14c and is administered by the
Department of Labor (DOL). In order to pay commensurate wages a nonprofit
must have a certificate from DOL. No matter the type of work, the output is
usually some measured fraction of a properly established standard. Based on
this productivity and the prevailing wage for the type of work being done, the
wages calculated may or may not be below the Federal or State minimum wage.
DSM– (DSM-IV or DSM-4) –Diagnostic and Statistical Manual of Mental
Disorders, 4th Edition (1994) – The principal reference book for psychiatrists,
psychologists, mental health counselors and therapists. It includes:
classifications and diagnostic codes, diagnostic criteria and symptoms, treatment
options, prognoses and research findings for all mental disorders.
Five Axis Assessment – A multi-axial summation from DSM-4, each of which
refers to a different domain of information:
Axis I: Clinical/mental Disorders and syndromes such as schizophrenia
and bipolar disorders.
Axis II: Personality Disorders; developmental disorders. Includes
diagnoses such as paranoia and antisocial personality disorders, and
others like autism and mental retardation.
Axis III: General Medical Conditions; Includes physical conditions such as
decreased function due to a brain injury.
Axis IV: Psychosocial and Environmental stressors
Axis V: Global Assessment of Functioning (GAF) Scale: rated with
respect only to psychological, social, and occupational functioning; does
not include impairment in functioning due to physical or environmental
limitations.
Medical documentation – documents that contain a clear diagnosis of what
condition or combination of conditions has resulted in an individual being
considered to be severely disabled. [Ref. 41CFR51-1.3]. All verifying medical
37
documentation must be signed by a person who is qualified to make such an
evaluation. [Ref. 41CFR51 - 4.3] Depending on the disability, the age of the
documentation is relevant in that some disabling conditions can improve over
time. [Ref. 41CFR51 - 1.3(2)]
Normal competitive employment – commonly refers to general workplace jobs,
for which all individuals compete. Any given individual may obtain such a job by
any means, but must be able to maintain it with reasonable accommodations and
without external supports from a CRP or nonprofit agency. It is full time
employment, with the same wages and benefits as non-disabled co-workers
assigned to the same activities.
Pre-admission evaluation – an initial evaluation (and usually referred to as
such) for an employee’s capability for normal competitive employment that is
done within the individual’s first 30 days at the nonprofit. In this formalized
process, staff assess the employee’s capacity for certain tasks, limitations
engendered by their severe disability, and how the latter might be
accommodated. An individual’s non-competitive employability is determined
here.
38
Examples of Acceptable Documentation
The following examples are from various JWOD nonprofits. They represent
several different approaches to documenting competitive employability and
whether an individual meets or doesn’t meet the Committee’s requirements. It
must be stressed that these are not the only ways of meeting the Committee’s
requirements, but are offered as examples to assist nonprofits in integrating the
JWOD requirements into their other processes and procedures.
39
Competitive Employment evaluation
Date; January 17, 2006
Name: Doe, Jane
SSN: XXX-XX-XXXX
DOB: 07/12/66 (40)
JWOD Type: Annual
Position: Janitor
History
Ms. Doe has been employed with AIS since 02/04/03. Initial JWOD review found Ms.
Doe to be eligible based on mild Mental Retardation. Ms. Doe has been married for 12
years and has two children ages 7 and 10.
Regarding her work history, she reported that she has worked as an exotic dancer, off and
on since she was 20 years old. She worked doing cleaning for a company in the late
1980s, but stopped working there around 1988. She has also worked at a fast food
restaurant for one year and tried working as a waitress for a restaurant/bar but was not
kept beyond her trial period. She also had her own kiosk in a local mall briefly but her
employer told her that she was too slow and she was let go. In the past, she has
occasionally sold Avon.
Medical Review
A Psychological Evaluation was performed by Jan Smith, Ph. D. on 01/11/06. Dr. Smith
diagnosed Mild Mental Retardation and dysthymic Disorder. A WAIS – III was
administered and the results were a Verbal IQ of 61, Performance IQ of 69, and Full
Scale IQ of 69 which is in the Extremely Low Range of intellectual ability. The Trail
Making Test identified mild-moderate organic brain impairment. The WRAT3 showed
skills and spelling to be at the 4th grade level and math skills to be at the 3rd grade level.
The RAVLT found that Ms. Doe requires longer-than-average learning time for new
material.
The MMPI-2 was administered in an audio-taped version because of Ms. Doe’s low
reading abilities.
40
Dr. Smith reported that Ms. Doe has a limited level of executive abilities which leaves
her with deficits in the ability to plan, organize, self-monitor, and accommodate for
mistakes or variability in performance. Her personality structure is such that she tends to
appear aloof and may have poor interpersonal skills which would leave her prone to
social isolation from an avoidance of others. She may suffer from mild, chronic
depression.
Ms. Doe will most likely need ongoing help with planning, organizing, prioritizing, and
making modifications in her work performance. She is capable of learning verbally but
her learning time is most likely much longer than for others. This is complicated by her
tendency to avoid relaying information regarding deficits, to include non comprehension.
It would be advisable for hr and supervisors to have her repeat instructions, to verify that
she has understood them.
Personnel File Review
No findings of disciplinary action, incident reports, or any indication of behavioral issues
on the job.
Supervisor Review
On 12/02/05, a phone interview was conducted with Ms. Doe’s supervisor, Don Jackson.
Mr. Jackson reported that Ms. Doe completes a full eight hours worth of tasks within 8.5
hours. The reason for the extra 30 minutes is that Ms. Doe works at 2 separate sites
during her eight hour shift. After she finishes her tasks at one, she has to walk to the
other, in the dark. This makes her nervous and the anxiety causes a performance deficit.
Mr. Jackson stated that Ms. Doe is able to adapt to changes in her routine, as long as she
has additional time to adjust, have all of her questions answered, receive close
supervision, and be comfortable that extra support is available if she needs it. Given this,
she can adjust to occasional change. However, day to day changes would markedly
reduce her productivity, as it would begin to overwhelm her. She can adapt to a new site,
as long as her duties are relatively the same.
Mr. Jackson also reported that Ms. Doe’s mental processing is slow, especially when
questions are asked. Either the questions are not well understood, or an extended period
for deliberation is needed. He stated that she has difficulty making decisions and using
good judgment while performing her various tasks. He provided an example:
Ms. Doe has a tendency to carry a bucket from one end of the school to the other, in order
to clean a room. On completion, she will store the bucket in the closet closest to the
room. The next time she cleans that room, she will carry a different bucket from one end
of the school to the other. After not too long a period, all of the buckets in the school will
be in one closet at the far end of the school. He stated that she persists with this,
regardless of the number of times he has explains this problem to her. She is able to learn
new tasks with verbal instructions, but that time must include slow simple explanations,
modeling, supervising and providing reminders.
41
Mr. Jackson reported that Ms. Doe left her husband recently and she has requested a shift
and site change. For the most part, she is very uncomfortable talking to people,
especially if she does not know them.
Ms. Doe needs to be placed at a work site where she is only expected to perform one task
at a time. He stated that she requires 4-6 hours of direct supervision in order to insure
that her tasks get completed, And Sometimes he has to assign part of her work to janitors
on the next shifts. He stated that she is not able to multi-task, prioritize her tasks, or time
manage her shift. He stated that he often finds Ms. Doe in the middle of a task, confused
as to which step comes next. He stated that he had not been able to be present at Ms.
Doe’s work site until recently, and did not realize how much she was struggling with her
job duties.
Employee Review
On 12/20/05, a phone interview was conducted with Ms. Doe. She reported that she
graduated from high school, but is “not a real exceptionist in math.” She was in Special
Education and is able to read and write.
She stated that she “took training on computers” in the past, but has not used those skills
for work. She said that she has worked with the Office of Vocational Rehabilitation
Services, and that agency may have been the one who referred her to AIS.
When asked whether she received SSI or SSDI, she said that she used to a long time ago
but that she does not anymore. When questioned as to why it was stopped, she answered,
“1988.” The question ‘why’ was repeated and she then answered “I guess because I was
working.
Ms. Doe stated that she became anxious at times and has trouble breathing when she did.
At such times, she must relax and breathe. She stated that this has been a problem all her
life.
She has not seen a doctor for quite some time and takes no medications.
However, she said she needs to see one soon, because she has “an infection.” When
questioned about this, she stated that she did not want to share the information, because
she is self-conscious.
She has two children, but when asked their ages, she responded, “I also have property
taxes and the county one,” quickly adding, “My husband is injured.”
Ms. Doe then began talking about how she had avoided another job, but that Child
Protective Services (CPS) was called because of something in the driveway and she was
charged $1,000. She began to talk about this situation at length but it was difficult to
follow the events because she presented them in a scattered and fragmented manner.
In response to whether or not she experienced any difficulties in performing her job
duties, Ms. Doe stated, “I assist the night custodian and learned lots here. Most important
to get things done and do the fire alarms. The question was reworded, “Do you have any
problems at work?” In response to this, Ms. Doe stated, “I get confused about what to
42
do, you know, um.” After a long silence, she stated, “There are a few other things like
fire alarms. Well, it’s a practice thing.”
During the conversation, Ms. Doe appeared hesitant and guarded when answering direct
questions. Most questions resulted in pauses that lasted for at least ten seconds before
she responded. Her answers were delivered with very slow, halting speech. However,
when she related her CPS story, she spoke without hesitations and more quickly than
when responding to direct questions, where her answers often related to completely
different subjects.
Recommendations
Ms. Doe has Mild Mental Retardation and a Dysthymic Disorder. She processes
information slowly and has difficulty learning and executing new tasks. Her Dysthymic
Disorder produces occasional depression. During such periods, she has a low energy
level and has difficulty concentrating on her work.
Ms. Doe will benefit from a structured environment and a set single-task routine, with
minimal distractions, interruptions, or changes. She needs to be supervised closely and
given reminders to help her complete her tasks correctly and in a timely manner. New
tasks should be demonstrated to her with both verbal and manual instructions and, with
additional time to learn them. Interaction with others should be limited, since it makes
her very uncomfortable. She will benefit from encouragement and support on a daily
basis.
Assessment/Plan
Based on this review, I believe that Ms. Doe does have a severe disability that is
consistent with JWOD regulations. She demonstrates an inability to overcome the
functional limitations of self-care, self-direction, work skills, work tolerance, and
communication associated with Mild Mental Retardation and Dysthymic Disorder.
These functional limitations preclude her from obtaining and maintaining competitive
employment.
I hereby find Ms. Doe to have a severe disability which so limits her functional
capabilities that she is unable to engage in normal competitive employment over an
extended period of time in accordance with JWOD standards Title 41 Part 51-1.3.
JWOD Eligible: Yes
Primary: Mild Mental Retardation
Secondary: Dysthymic Disorder
XX
Disability/Eligibility Specialist
43
Rev. 1/05
INITIAL EVALUATION
Supervisor: Please check the box below that best describes your new hire.
External Hire – Disability documentation specifies competitive employment statement
and limitations.
Rehire – Disability documentation on file.
Qualifies as a Schedule A hire – Previous federal employee with a disability.
Initial Evaluation was conducted by management within 30 days (complete the
reverse side of this Initial Evaluation if the above descriptions are not applicable).
Comments
Signature
Date
Title
INITIAL CHECKLIST
Adequate for
Competitive
Interferes with
Competitive
Employment
Employment 1
1
WORK HABITS
Attendance
Punctuality
Proper Notification when absent/late
Takes breaks at designated time
Leaves premises at designated times
44
Explain
WORK TOLERANCE
Attention to work details
Frustration tolerance
Follows written directions
Follows oral directions
Ability to maintain expected work pace
Productivity rate
Reaction to new assignments
Need for work assignment accommodation
INTERPERSONAL BEHAVIOR
Interaction with supervisor
Interaction with co-workers
Demonstrates effort to work
Management of conflict
Ability to work without direct supervision
OTHER (what supports are being provided to
the employee)
45
WORK SKILLS RATING SCALE
Competitive Employability Determination
DATE __/__/__
INITIAL ___ Or ANNUAL ___
DISABLED EMPLOYEE __________________________ WORKSITE ______________________
EVALUATOR____________________________JOB TITLE_______________________
Please rank this disabled employee’s level of ability and performance , compared to that
of a non-disabled, competitively employed individual, who is performing similar tasks.
Rate each level of functioning by placing an”X” in the area which most closely describes
the disabled employee’s current performance.
WORK SKILLS
RATINGS: Functional Limitations
A. ATTENDANCE
(Mark one)
B. Degree of
Present 95% or more
Present 51% -94%
Support provided
Present 50% or less
95% or more
76% to 94%
51% to 75%
50% or less
95% or more
8o% or 94%
60% or 79%
59% or less
INDEPENDENCE
C. WORK HABITS
% of time consumer
is:
1. PUNCTUAL
2. COOPERATES
with co-workers
3. COOPERATES
with supervisors
4. Shows
INITIATIVE by
seeking work
5. ATTENTIVE to
assigned tasks
6. Displays good
APPEARANCE
and/or HYGIENE
7. Accepts
REDIRECTION
8. DEPENDABLE in
completing tasks
9 Observes
SAFETY rules &
regulations
10. Follows
DIRECTIONS
46
11. COMMUNICATES
Effectively
12. Accepts
CHANGE appropriately
13. Works well
under PRESSURE
14. Identifies quality
control issues
Supports provided
D.
Work Tolerance
RATINGS: Function Limitations
1. Demonstrates
6-8hr. work day
4-6 hr. task
2-4 hr. task
Less than 2 hrs.
95% or more
80% to 94%
60% to 79%
59% or less
90% or more
70% to 89 %
50% to 69%
Less than 50%
STAMINA for
SKILLS:
% of time employee
is able to:
2. Uses required
TOOLS and
EQUIPMENT
appropriately
3. LEARNS NEW
TASK quickly with
minimal instruction
4. COMPLETES
TASKS without errors
5. Makes fine
DISCRIMINATIONS
6. Correctly
MANIPULATES
small objects/items
Percentage of total job
description performed
47
Index (NOT FINISHED)
Competitive employment, page 5
Definition
Evaluator’s background, pages 8 - 9
Indirect factors, page 9
Productivity considerations, page 9
Taking on workers from an existing commercial contract, pages 9 - 10
48