PPS Interview

Turning hope into action

Reprinted from Recovery, May 2004

Ask Lori Mashek about her job and her eyes light up like headlights and a big, beaming smile jumps to her face.

Im a Certified Vocational Rehabilitation Councilor for the state of Oregon. I help people with various kinds of disabilities get back to work. Each day is totally different because each client has a different set of challenges and opportunities. I get to sit down, nose-to-nose, and help them develop a goal and a strategy to reach that goal. They might not always end up exactly where they thought they were going, but most of the time I see despair turn into hope and hope into action. I see the joy in their eyes when they overcome what they thought were insurmountable obstacles. Most of the time, if they trythey win! Thats why I love my job!

The Americans with Disability Act of 1990 is a law that requires employers with more than 15 workers to make reasonable accommodations in the workplace for people with disabilities. (See box on next page.) Each state in Americaand many nationshave Vocational Rehabilitation Councilors (VRC), because getting people back to work is good for citizens and good for the government, financially and otherwise.

To be a Certified VRC an applicant must have a Masters Degree and pass the grueling federal licensing examination. Some VRCs work for insurance companies and focus primarily on saving the insurance company money. But Lori works for the state and her priority is to help clients overcome their disabilities; there is no doubt that pemphigus and pemphigoid can be debilitating.

My first job is to determine the extent of the disability. I discuss the clients interests, abilities, transferable skills, aptitudes and education level. This can be a very difficult process for those people who have not yet come to grips with the fact that their disabilities may require a lifestyle change.

For pemphigus and pemphigoid patients, this is complicated by the fact that patients dont know in advance about the timing, severity or duration of symptoms, so making plans is extremely difficult. This adds another magnitude of difficulty to the equation.

Age is a factor, too. Older patients are often at the top of their careers and earning potential. Their age and experience level present much different options and obstacles than someone younger.

Once limitations are determined, we look at vocational goals and possible career changes that are a good match for client. We work with doctors, physical therapists and other specialists to make sure each patient takes advantage of every program or tool. I educate them about their disability, any functional limitations and measure how willing they are to cooperate. Attitude is of obvious importance. Some clients need to survey the labor market themselves to find a job that matches their profile, and achieve their employment goal, because they may not fully realize or accept the extent of their disabilities. Once they decide what they want to do an Individual Employment Plan (IEP) is developed.

An IEP is a contract between the client and State. It lists the tools and services available from and necessary for the client to overcome his disabilities. When the client signs the contract he promises to participate, follow through and be enthusiastic.

States can provide many tools and services to support a disabled patients efforts to find or keep a job. This includes things like an ergonomic workstation, training in new field or career, voice activated software, wheelchairs or scooters, transportation (a bus pass), medication or counseling. (Counselling is limited to a short term, often dealing with grief; [i.e. loss of former capabilities], anger management or depression; common obstacles for newly disabled patients.) In some cases a job developer or job coach is called in. Job developers look for a job that meets the clients capabilities and goals, while a job coach is someone who helps the client learn the job and perform the duties required. What is provided varies widely.

In the past Ive asked for a leave of absence under the Family Leave Act, flexible hours, job sharing. One client suffered a stroke and we got the employer to allow the client to return to work by gradually extending hours so he could get back into shape physically and mentally; this is called work hardening. In one instance a client was allowed to use a calculator because simple math became difficult, a tape recorder for memory, and given a stool since she could not stand for long periods of time. A diabetic required mini-breaks to eat or go to the bathroom. And one time I even got a client teeth.

Sometimes Im asked to educate the employer or coworkers. I explain the illness to verify the clients limitations, dispel ignorance and fear that makes the workplace uncomfortable for everyone, and affects the clients ability to perform his duties. Sometimes it takes a phone call from me to convince the employer that the ADA applies to them. Sometimes it takes a letter from our attorneys. Only very rarely do we sue an employer, but that is an option.

In the end, a client simply might not be able to perform the job. Then they need to find another job, work part time, work through a temp agency, or perhaps stop working altogether temporarily or permanently. This is where Social Security may come in. There are other options, too, and a VRC can help a client find alternatives.

If client has been a good employee, then an employer usually tries harder to make accommodations, but there are limits. The law says the accommodations have be reasonable and what is reasonable is determined on a case by case basis. A big company might have more options than a small one, but sometimes the reverse is true. Thats what makes this job such a challenge for me. Sometimes I have to be very clever, sometimes I have to be sweet and sometimes I have to be firm and direct.

Above all else, the client needs to take an active role in the process. Anything becomes difficult without a positive attitude. A client has the responsibility to follow the doctors orders; eat right and get plenty of rest, to be able to over come as much of the disability as possible. They have to manage their medications, stress levels and moods as much as possible to make things as productive as possible. They need to become an expert in their disease so they can make good choices for themselves. They need to be a good advocate for themselves, but that doesnt mean arguing with the boss, it means showing the boss how making the accommodations are good for his business.

Lori recently received an award from the Oregon Small Business Asso-ciation. She was recognized for helping a client whose solution was not to find an accommodation with an employer, but to go into business for himself. Lori went above and beyond the call of duty to help this patient get started, and the client did the rest. That was an extra layer of icing on my cake. Loris smile is a mile wide. I LOVE MY JOB!

Patients need to stop thinking like a victim, she says. They may not have all the physical or mental capabilities they once had, and they may not have total control of things, but they need to do the very best they can with what they do have. In most cases, a positive attitude and real effort pays off and makes all the difference in the world. If theres a will, most often theres a way.

Americans with Disabilities Act

Return to news menu