Vocational Rehabilitation

Being gainfully employed in a fulfilling and rewarding job is very important to most people. Our jobs help to define who we are. They give us a sense of well-being and independence, as well as economic stability and a sense of belonging in our communities.

One of the most difficult things about multiple sclerosis (MS) is that it can affect your ability to continue to work, even though you may have qualifications and experience that make you valuable in a variety of different occupations. As MS progresses and disability increases, people often decide to leave the workforce. In the US, about 40 to 45 percent of people with MS are employed.

Reasons for leaving the workforce

Research has identified a number of factors that may influence a person with MS to leave the workforce. However, since work and employment circumstances vary from person to person, we still do not understand why one person with a certain level of disability will decide to stop working while another with a similar level of disability will continue to work.

A number of factors can predict whether a person with MS will leave the workforce, such as:¹

• Increased cognitive impairment
• Limited formal education
• Employed spouse
• Physically demanding occupation
• Poor relationship with employer
• Coworkers with negative attitude
• Progressive disease course
• Employment involving out-of-door labor
• Severe physical symptoms affecting mobility
• Discrimination in workplace

Vocational rehabilitation

The good news about MS and employment in the United States is that there are more legal protections and provisions now than at any time in history to help keep people with MS who want to continue to work in the workforce.

Before you make a decision about whether to leave the workforce, you should know about relevant legal protections, such as the Americans with Disabilities Act (ADA), and employment services and resources that can help you continue to work. These services include vocational rehabilitation (VR), occupational therapy, job retention programs, and advocacy programs. The US Department of Labor’s Job Accommodation Network, known as JAN, is one resource that provides information regarding your legal rights and accommodation strategies and options.

Vocational rehabilitation (VR) in the US is a government program run by individual states (how the program is run varies from state to state) set up in accordance with the Rehabilitation Act of 1973, a law stipulating that services must be provided to help disabled persons become or remain employed. If you want to take advantage of VR in your state, you must demonstrate that you are eligible to participate in the program, which means that you must show that you have a physical or mental impairment that constitutes a substantial impediment to working. You must also stand a reasonable chance of becoming employable by using the services offered to you through the VR program.

These services typically include:

• An assessment of the extent of your disability and need to correct or compensate for your disability
• Vocational counseling and guidance
• Use of assistive or adaptive technologies (medical appliances or prosthetic devices) that increase your ability to work
• Vocational training to help you find gainful employment
• Job placement services
• Services that follow up on your program after you find a job