Employment, Vocational, and Community Integration
The vocational frame
Employment work is usually collaborative: the state-federal vocational rehabilitation agency holds the case, and the CVRT contributes functional information, work-related ADL and communication training, and accommodation recommendations. Understand the individualized plan for employment, eligibility, order of selection, comparable benefits, and post-employment services. Know the ADA: Title I covers employers with 15 or more employees, requires reasonable accommodation - magnification software, screen readers, braille production, schedule adjustments, reassignment in some cases - and prohibits discrimination. Disclosure is the employee's choice, and accommodation is requested, not demanded. Know enough about Schedule A federal hiring, Ticket to Work, and SSDI/SSI work incentives to refer for benefits counseling.
Address the practical substrates of work: transportation, grooming and wardrobe, meal planning, time and medication management, social communication, and technology. Job analysis identifies essential functions and specific visual demands, which drives the accommodation plan. Supported employment, self-employment, volunteering, and gradual return to work are all legitimate paths.
Traps
Blaming unemployment on vision when transportation, benefits traps, or discrimination are the real barriers; assuming disclosure is mandatory; assuming a physician's note settles the accommodation question; ignoring the consumer's career goals in favor of a default 'realistic' option.
Worked example
An accounting clerk who reads dense spreadsheets loses acuity. Rather than assuming a career change, analyze the job: the essential function is accurate reading and entry of data. Recommend a large monitor with magnification and high contrast, screen reader support for verification, and OCR for scanned documents - then train and reassess productivity.
Rule of thumb: analyze the job before rewriting the career.