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Vocational rehabilitation services and employment for SSDI beneficiaries with visual impairments
Abstract
BACKGROUND
A considerable proportion of Vocational Rehabilitation (VR) consumers with visual impairments are Social Security Disability Insurance (SSDI) beneficiaries. The consumer and the effectiveness of VR and the Social Security Administration can benefit from greater understanding of the processes leading to improved employment outcomes for this population.
OBJECTIVE
Our purpose was to investigate service patterns and evaluate the impact of VR services on competitive employment outcomes for consumers with visual impairments who also are SSDI beneficiaries.
METHODS
Using FY 2011 RSA-911 data on 3,610 consumers who received SSDI, closed after receiving services, we conducted descriptive, factor analytic, and multilevel analyses to determine service patterns and what services predicted competitive employment.
RESULTS
We found service groupings related to special and remedial services, job-related services, evaluation, and training and supports. Job placement, job search, on-the-job supports, on-the-job training, counseling and guidance, rehabilitation technology, other services, and maintenance were positively related to competitive employment, but reader services, interpreter services, job readiness training, augmentative skills training, and assessment were negatively related to employment.
CONCLUSIONS
Pattern groupings of services suggest a systematic, holistic approach in VR. A new perspective is needed when examining the service-outcome relationship. Services positively related to competitive employment can have direct, direct-assistive, or indirect effects. Services negatively related to employment can be viewed as risk indicators.
... Brennan et al. [14] deployed a longitudinal design to examine cause-and-effect relationships across time for people with a specific age-related eye disease. Giesen and Hierholzer [89] described their methodology as multilevel, and purposed to evaluate service patterns and the impact of VR on employment outcomes for people with BVI receiving social security benefits [9]. Concentrated on the service structure of VR for people with BVI and an identified mental illness, Dean et al. [62] formulated a multivariate model to capture service provision choices and corresponding service receipts. ...
... Five studies quantitatively explored the factors that predict employment outcomes for people with BVI, including the assessment of VR service patterns and classification. The earliest study to investigate was a multilevel analysis by Giesen and Hierholzer [89], who explored VR service patterns and evaluated the potential employment outcomes for people with BVI using FY 2011 rehabilitation services administration (RSA-911) data on consumers (N = 3610) who also received social security disability income (SSDI) [9]. Results indicated that services are delivered in clusters, such that the higher correlations of services within clusters inform services within factors that tend to be received together. ...
... Results indicated that services are delivered in clusters, such that the higher correlations of services within clusters inform services within factors that tend to be received together. Regarding evaluation services (ie, factor), which are inclusive of mental health services, only two of the four services in this factor group were related to employment outcomes: VR counseling and guidance and assessment [89]. Results from this study indicated that people receiving VR counseling and guidance have 32% higher odds of competitive employment, whereas assessment services indicated 34% lower odds of competitive employment. ...
The present study highlights the Role of Rehabilitation Medicine in the Psychological Etiology of Blindness or Visual Impairment
... Five studies quantitatively explored the factors that predict employment outcomes for people with BVI, including the assessment of VR service patterns and classification. The earliest study to investigate was a multilevel analysis by Giesen and Hierholzer, 86 who explored VR service patterns and evaluated the potential employment outcomes for people with BVI using FY 2011 rehabilitation services administration (RSA-911) data on consumers (N = 3610) who also received social security disability income (SSDI). Results indicated that services are delivered in clusters, such that the higher correlations of services within clusters inform services within factors that tend to be received together. ...
... Regarding evaluation services (ie, factor), which are inclusive of mental health services, only two of the four services in this factor group were related to employment outcomes: VR counseling and guidance and assessment. 86 Results from this study indicated that people receiving VR counseling and guidance have 32% higher odds of competitive employment, whereas assessment services indicated 34% lower odds of competitive employment. Information and referral services and technical assistance services were not significantly related to outcome. ...
... In any case, it was suggested that such services are considered a "risk" to employment outcomes. 86 Similarly, Lund and Cmar's 95 recent systematic literature review postulated the potential "risk" for VR consumers with BVI to have unsuccessful closures due to poorly targeted supports and interventions, particularly those receiving SSDI. McDonnall et al 94 also postulated this same risk, stating that people with BVI who are also receiving SSDI may be at risk for poorer employment quality. ...
Purpose
Roughly 3 million adult Americans have a visual impairment or blindness, and over 4 million adults aged 40 and older. Despite data demonstrating an elevated prevalence of mental health symptoms in people with BVI, this population remains largely untreated. Given that people with BVI often interface with multiple systems of rehabilitative care that are designed to improve quality of life, the relatively low rates of initiation of mental health care services are particularly alarming. In this review, the systematic processes of mental health care services across pertinent rehabilitation groups are identified and critically examined.
Patients and Methods
A comprehensive literature review was conducted. The literature review utilized a critical systems typology, whereby relevant literature was selected, reviewed, and analyzed intra and extra organizationally. In addition, a thorough discussion of disability-related factors was provided, lending a socio-political lens to the problem.
Results
Considerable data indicates that short-term mental health care services for people with BVI are ineffective treatment methods, albeit primarily employed in health-rehabilitative processes. Multiple studies offered data indicating the presence of diverse and entangled mental health issues relative to vocational rehabilitation services, mobility tool utility, and emotional reactions to vision loss. Many studies suggested that disability identity work be integrated into health-rehabilitative processes for people with BVI.
Conclusion
To improve the utility of mental health care services for people with BVI, a reenergization of the mental health care needs of this population must occur. A critical podcast or forum focused on educating listeners about the health-rehabilitation factors that influence the provision of mental health care services can aid to improve future mental health policy and practice for people with BVI. Disability scholars need to advance research on integrating critical theories in work with people with BVI and accelerate qualitative, community-based methods to enhance understanding of this population and their unique mental health needs.
... These studies were all performed in the United States or Asia, but not in Europe. Study samples with a majority of their participants, who were or had been in a VR setting, [49][50][51][54][55][56][57][58][59][60]62,63,65,67,69,71,78,82,[87][88][89][90][91] reported a somewhat higher employment rate mean compared with samples not from a VR setting; 50% and 46% respectively. Moreover, six studies investigated the association between different types of VR services and employment. ...
... Moreover, six studies investigated the association between different types of VR services and employment. 55,58,62,67,69,90,92 Twenty-seven different types were assessed, which could be grouped into four categories, as suggested by Giesen et al. 58,67 based on service delivery patterns: Special and Remedial Services, Job-Related Services, Evaluation and Training and Supports. Tables 2 and 3 show the methodological quality of the individual studies, measured with the NOS. ...
Introduction:
The aim of this systematic review and meta-analysis was to assess factors associated with work participation in people with visual impairments and to explore how these factors may have changed over time.
Method:
A comprehensive search of PubMed, Embase.com, EBSCO/APA PsycInfo, EBSCO/CINAHL and EBSCO/ERIC from database inception to 1 April 2022 was performed. We included studies with cross-sectional design, case-control, case-series or cohort design, involving visually impaired working-age adults with at least moderate visual impairment, and evaluated the association between visual impairment and work participation. Studies involving participants with deaf-blindness or multiple disabilities were excluded. We assessed study quality (Newcastle-Ottawa Scale [NOS]), examined between-study heterogeneity and performed subgroup analyses. The study protocol was registered in PROSPERO, CRD42021241076.
Results:
Of 13,585 records, 57 articles described 55 studies including 1,326,091 participants from mostly high-income countries. Sociodemographic factors associated with employment included higher education (odds ratio [OR] 3.34, 95% confidence interval [CI] 2.47 to 4.51, I2 0%), being male (OR 1.59, 95% CI 1.37 to 1.84, I2 95%), having a partner (OR 1.73, 95% CI 1.12 to 2.67, I2 34%), white ethnicity (OR 1.36, 95% CI 1.07 to 1.74, I2 0%) and having financial assistance (OR 0.38, 95% CI 0.26 to 0.55, I2 85%). Disease-related factors included worse visual impairment (OR 0.61, 95% CI 0.46 to 0.80, I2 98%) or having additional disabilities (OR 0.55, 95% CI 0.49 to 0.62, I2 16%). Intervention-related factors included mobility aid utilisation (OR 0.35, 95% CI 0.10 to 1.18, I2 94%). A potential moderating effect of time period and geographical region was observed for some factors. Study quality (NOS) was rated moderate to high.
Conclusion:
Several sociodemographic and disease related factors were associated with employment status. However, the results should be interpreted with caution because of overall high heterogeneity. Future research should focus on the role of workplace factors, technological adjustments and vocational rehabilitation services on work participation.
... We found evidence that interventions to improve vision and functional ability reduce poverty and improve economic prospects (table 2). [15][16][17][18][19][20][21][22][23][24][25][26] For example, provision of free spectacles to tea workers with presbyopia in India improved workplace relative productivity. 15 Prospective cohort studies showed increases in household per capita expenditure in people with vision impairment who underwent cataract surgery. ...
... Household income (four studies) Several prospective cohort studies showed that household income increased after cataract surgery; 18-20 for example, 1 year after provision of cataract surgery in marginalised communities in rural India, the proportion of households with a monthly income <1000 rupees decreased from 51% to 21% (p=0·05) ·· One retrospective cohort study showed that, in people who became legally blind by the age of 6 years in the USA, those who attended specialised schools for people with vision impairment had a lower salary than those who attended public schools, although this difference could have been confounded by other determinants 21 Employment rates (one study) A retrospective cohort study showed that some vocational rehabilitation services for people with vision impairment in the USA were positively associated with paid employment; for example, training and support services were associated with increased odds of obtaining paid employment (odds ratio 1·10; p=0·001) 22 Economic productivity (four studies) Cost-effectiveness and cost-evaluation studies showed benefits to economic productivity from cataract surgery 23,24 and trichiasis surgery; 25,26 for example, one study showed that there was a net 13 year US$123·4 billion return on investment from a 1 year cohort of patients who had had cataract surgery, which included an increase in US national productivity of $25·4 billion 23 ...
UN member states have committed to achieving the Sustainable Development Goals (SDGs) by 2030. This Review examines the published evidence on how improving eye health can contribute to advancing the SDGs (beyond SDG 3). We identified 29 studies that showed direct benefits from providing eye health services on SDGs related to one or more of poverty (SDGs 1, 2, and 8), education (SDG 4), equality (SDGs 5 and 10), and sustainable cities (SDG 11). The eye health services included cataract surgery, free cataract screening, provision of spectacles, trichiasis surgery, rehabilitation services, and rural community eye health volunteers. These findings provide a comprehensive perspective on the direct links between eye health services and advancing the SDGs. In addition, eye health services likely have indirect effects on multiple SDGs, mediated through one of the direct effects. Finally, there are additional plausible links to other SDGs, for which evidence has not yet been established.
... This Commission explored the relationship between eye health and general health and wellbeing (SDG3) in six separate reviews, as well as doing a further review on the relation between eye health and the 16 other SDGs (appendix 1 p 15; table 2). 57 In terms of these 16 SDGs, we showed that the provision of eye care services is associated with improvements in workplace productivity, 29 household consumption, 30,31 household income, 32-35 employment prospects, 36 and economic productivity. [37][38][39][40] Economic benefits, particularly in resource-limited communities, contribute to achieving SDGs such as poverty reduction (SDG1), food security (SDG2), and decent work (SDG8). ...
... Household income increased after cataract surgery-eg, 1 year after provision of surgery for marginalised communities in rural India, 32-34 the proportion of households with a monthly income (<1000 Rupees) decreased from 51% to 21% (p=0·05); in the USA, 35 children who became blind by age of 6 years and attended vision impairment schools had a lower salary than those who attended public schools (possibly confounded by other determinants) Employment rates One (retrospective cohort study) Vocational rehabilitation services for vision impairment in the USA were positively associated with paid employmenteg, training and support services increased odds of obtaining paid employment (odds ratio 1·10, p=0·001) 36 Economic productivity Four (cost-effectiveness and evaluation studies) ...
... Finally, some studies examined particular types of vocational rehabilitation services. Leonard et al. (1999), for example, found that assistive technology, training, and orientation and mobility (O&M) improve employment outcomes (also see Giesen & Hierholzer, 2016). ...
... Rather than focus on a binary treatment variable, Giesen and Hierholzer (2016) used a statistical factor model to identify four key service categories. Schmidt et al. (2019) aggregated the detailed service information to seven categories. ...
Introduction
This study describes the characteristics of, services received by, and labor market outcomes of applicants with visual impairments to three state vocational rehabilitation programs. Our objective is to both document cross-state variation in vocational rehabilitation clientele and services and provide new insights on the longitudinal labor market outcomes of clients with visual impairments (i.e., blindness or low vision). This analysis is a first step in assessing the returns to vocational rehabilitation services for this population.
Methods
We first created a unique longitudinal data set by matching administrative records on applicants who are visually impaired in state fiscal year 2007 from three vocational rehabilitation agencies to 8 years of employment data from state Unemployment Insurance programs. Using these data, we examined cross-state variation in the descriptive statistics for important client explanatory variables and vocational rehabilitation service categories. We then compared the long-term labor market outcomes of clients receiving services (treated) to untreated individuals.
Results
We documented two important findings. First, there were substantial differences in client characteristics, services provided, and costs across the three states. Second, the long-run labor market analysis was consistent with vocational rehabilitation services having no employment effect but a positive earnings effect.
Discussion
Labor market results indicate vocational rehabilitation services provided persistent earnings benefits. Yet the substantial cross-state heterogeneity suggests these labor market results might not be generalizable and should be interpreted with caution. We explain what was missing from this analysis and why the results should not be thought of as causal.
Implications for Practitioners
This article gives practitioners a sense of a unique new data set on vocational rehabilitation and labor market variables for applicants with visual impairments. We highlight the importance of cross-state variation and linking vocational rehabilitation data to long-term employment measures. The question of how best to inform the efficacy of different vocational rehabilitation strategies for clients with visual impairments is left for future researchers to consider.
... A few other studies have documented similarly large odds ratios associated with lack of employment and disability benefit receipt among people with visual impairments (Crudden & McKnight, 2022;McKnight et al., 2021). Smaller effects of disability benefit receipt have been observed in studies of state-federal vocational rehabilitation consumers (McDonnall, 2016;Steinman et al., 2013), which may reflect differences in characteristics between people who do versus do not seek these services and receive the benefits of these services (Giesen & Hierholzer, 2016;O'Neill et al., 2015). ...
BACKGROUND: A substantial gap in employment rates has been documented between people with and without visual impairments, but most employment-related research for people with visual impairments has focused on employment at one time point. OBJECTIVE: The purpose of this study was to examine longitudinal employment trajectories by visual impairment and investigate factors associated with trajectories for people with visual impairments. METHODS: The data source was the 2014 Panel of the Survey of Income and Program Participation. Participants were 816 adults with visual impairments and a matched comparison group of 816 adults without visual impairments. We used group-based trajectory modeling to estimate employment trajectories, identify predictors of trajectory group membership, and explore the impact of health on employment trajectories. RESULTS: Visual impairment was associated with a lower probability of membership in the Rising, Declining, and High employment trajectory groups compared to the Low group. Predictors of trajectory group membership included disability benefit receipt, non-visual disabilities, gender, race, age, and education. Fair or poor health was associated with decreases in all four trajectories over time. CONCLUSION: Visual impairment is a risk factor for not working across multiple years. Disability benefit receipt was the strongest predictor of trajectory group membership for this population.
... VR providers have long adopted a holistic approach to service delivery, (Giesen & Hierholzer, 2016;Osborne, 2014.). This holistic approach may be even more imperative for people with vision impairment who have other health or disability issues, or for people with recent onset of vision impairment. ...
BACKGROUND: Approximately half of people with vision impairments are not employed or looking for work. Many of these people have additional health or disability concerns, but little is known about those concerns or other reasons they are out of the workforce. OBJECTIVE: We investigated employment barriers impacting labor force participation among people with vision impairments, their perceptions of their skills and training needs, and the impact of not working on their economic status. METHODS: Thirty people with vision impairments who were not in the labor force participated in exploratory interviews conducted using a semi-structured protocol. We used a qualitative software program and multiple researchers to code the interviews, identify and analyze themes, and organize participants’ information. RESULTS: Employment barriers included concerns about health and disability, employer attitudes, transportation, training needs, economics, age, and lack of support. Some participants wanted to work now or in the past but were unable to find employment that accommodated their needs and generated a salary that made it economically worthwhile. CONCLUSION: Participants appear to need assistance identifying career paths leading to economic security, training for these careers, locating affordable transportation, and working with employers to gain workplace accommodations. Providing support and encouraging family support may positively influence interest in employment.
... Findings on the effectiveness of the three VR services have been mixed, and studies generally show that these services are either related to more positive employment outcomes, or unrelated to employment outcomes (Akinola et al., 2021;Brickham et al., 2016;Pete et al., 2015). Assessment and diagnosis and treatment of impairments are typically used to diagnose and/or treat health conditions and disabilities, so it is likely that individuals who received this service may have more severe disabilities and may require special attention or ongoing monitoring (Giesen & Hierholzer, 2016), thus complicating the VR process wherein the client achieves less-than-ideal employment outcomes. It is also likely that the negative associations found in this study were due to sampling error, because we only used data collected in FY 2020 at the peak of the pandemic, and these clients may have higher health care needs due to COVID-19. ...
This study examined the demographic and vocational rehabilitation (VR) service correlates of employment outcomes (achievement of competitive employment, hourly wage, and weekly hours) among individuals with substance use disorders (SUDs) during the COVID-19 pandemic, using the Rehabilitation Services Administration Case Services Report (RSA-911) database for fiscal year 2020. Data from 9,536 individuals were analyzed. Hierarchical logistic regression and hierarchical linear regression analyses revealed that multiple demographic and VR service variables were significantly associated with achievement of competitive employment, hourly wage, and weekly work hours at exit. Particularly, having a vocational training license/certificate, employment at Individualized Plan for Employment, and having an associate or bachelor’s degree were the strongest demographic correlates of more positive employment outcomes; while short-term job supports, maintenance, and other services were the strongest VR service correlates of more positive employment outcomes. Implications of the findings were discussed to promote VR service outcomes for people with SUD in the postpandemic era.
Background: To improve employment outcome, systematic research that is based on demand-side needs is needed to clarify how employer practice factors can affect customized training efforts.
Objective: The purpose of this study is to report the results of a scoping review to identify the best employer practices that are used to improve customized training efforts and results for people with disabilities in the workplace.
Method: A scoping review of demand-side employment literature was conducted. Five databases were searched for articles published between 1985 and 2017. After filtering articles based on the search criteria, the final number of articles included in the analysis was 27.
Findings: We identified three key themes related to customized training efforts. These include: (a) employment support, (b) work values, and (c) employment temperature.
Conclusion: The findings of this scoping review provide valuable information for disability employment professionals and rehabilitation counselors to engage and assist employers in relation to customized training efforts.
The Workforce Innovation and Opportunity Act emphasizes promoting high-quality, competitive employment for people served by vocational rehabilitation (VR), but few studies have assessed VR consumers’ job quality. The purpose of this study was to investigate job quality and factors that predict the job quality of VR consumers with blindness or low vision (B/LV), taking into consideration their employment status at application. We utilized RSA-911 data of VR consumers with B/LV who were closed in competitive employment during 2015, creating two separate hierarchical linear models to predict job quality for VR consumers (a) who were employed at application and (b) who were not employed at application. We investigated individual-level (consumer personal characteristics and VR services) and state/agency-level predictors. Job quality and some predictors of job quality differed by employment status at application, although the strongest predictors (education level at application, gender, benefit receipt at application, receipt of a bachelor’s or higher degree) were consistent across the models. While several additional individual-level variables were significantly associated with job quality, their effect sizes were very small. With the exception of advancing education to a bachelor’s degree or higher while receiving services, consumer characteristics at application were the primary determinants of their job quality.
Introduction
The purpose of this article was to conduct a systematic review of peer-reviewed studies on factors related to employment in consumers who are visually impaired using Rehabilitation Services Administration (RSA-911) Case Service Report data.
Methods
We used database, hand, and ancestral search strategies to systematically identify peer-reviewed studies published between 1990 and August 2018 where researchers used RSA-911 data to address the target question. All included articles were coded by two reviewers for study and participant characteristics, quality indicators, and outcomes.
Results
Nine articles consisting of 14 analyses were included. Twelve analyses concerned employment outcomes; two concerned earnings. Researchers in most studies used large samples of 3,000 or more consumers and used multivariable analyses, most commonly multilevel logistic regression. Factors that consistently predicted lower employment across studies included presence of a secondary disability and legal blindness; higher education level consistently predicted higher employment, as did earnings and self-support at vocational rehabilitation application. Few analyses included state- or agency-level variables or specific vocational rehabilitation services.
Discussion
These results indicate that certain groups of vocational rehabilitation consumers with visual impairments may be at greater risk of unsuccessful closures; researchers should examine specific strategies that may improve outcomes in these groups. These results also highlight the importance of education in securing employment among people with visual impairments. Researchers should examine state- and agency-level variables that may affect outcomes as well as the effects of specific services on outcomes. Additionally, researchers should analyze factors that may affect employment quality as well as employment outcomes.
Implications for practitioners
Practitioners who are working with visually impaired people who do not have a postsecondary degree should encourage and assist their clients in obtaining one; practitioners may also wish to provide more targeted support for consumers from potentially high-risk subpopulations.
BACKGROUND
Approximately one-third of the working age population of persons with visual disabilities is employed. Recent federal legislation stressed the importance of VR services to assist employed persons with disabilities retain or advance in employment, but we know little about employed VR applicants.
OBJECTIVE
This study sought to identify and contrast characteristics and services received by VR consumers with visual disabilities based on employment status at application.
METHODS
VR cases from fiscal year 2015 were analyzed using logistic regression. The sample included 4,586 competitively employed applicants and 9,643 unemployed applicants.
RESULTS
Competitively employed applicants tended to be White non-Hispanic, older, more educated, and less likely to have non-cognitive disabilities. Competitively employed applicants tended to receive on-the-job supports, rehabilitation technology, counseling and guidance, technical assistance, and diagnosis and treatment.
CONCLUSIONS
Competitively employed applicants with visual disabilities have different characteristics and service patterns from unemployed applicants. VR counselors can anticipate applicants’ service delivery needs based on their employment status while considering individual goals and circumstances. Future research regarding job retention for competitively employed applicants who are blind or have low vision appears warranted.
We examined individual, socioeconomic, disability, service, and state-level factors predicting vocational rehabilitation (VR) closure earnings exceeding substantial gainful activity for Social Security Disability Insurance (DI) beneficiaries in VR who were blind or visually impaired (BVI). We used 2011 RSA-911 (Rehabilitation Services Administration) data from 3,505 individuals exiting VR. Using multilevel modeling, we found positive relationships for beneficiaries who were male, younger, African American; held higher education levels; were without additional disabilities; had higher earnings and DI benefits at application; received services related to job placement and on-the-job supports; did not receive “work basics” (job-readiness) training; received training/support services in rehabilitation technology and other supports; and resided in states with lower unemployment rates. Interactions with VR agency structure revealed compensatory effects—negative relationships for being female and for being older were overcome by receiving services in a blind (rather than combined) agency. We concluded that prior work experience of a DI-beneficiary consumer contributes substantially to high earnings likely to lead to benefits termination due to work for the BVI consumer exiting VR and may serve to level race/ethnicity differences in outcome. Policy recommendations include retaining separate VR agencies for BVI consumers and strongly encouraging work experiences for consumers in VR.
The purpose of this study was to investigate employment outcomes for vocational rehabilitation (VR) consumers with deaf-blindness, a population that has received no attention in the literature. The sample was obtained from Rehabilitation Services Administration Case Service Report (RSA-911) data and included 1,382 consumers with deaf-blindness identified as their primary or secondary disability whose cases were closed during fiscal years 2013, 2014, and 2015. Independent variables consisted of consumer personal characteristics and VR service-related variables. Two measures of employment outcomes were used: obtainment of competitive employment and a composite measure of job quality. Overall, the results indicate that several VR service-related factors are associated with whether deaf-blind consumers obtain competitive employment, but consumers’ personal characteristics are much more important in determining job quality. Implications for improving employment outcomes for consumers who are deaf-blind include providing job-related services, supporting educational advancement, and providing counseling and guidance. Results also support the importance of accounting for employment status at application in RSA-911 analyses and the efficacy of service provision by separate agencies for the blind.
The three studies in this research investigation are based on analyses of FY 2011
RSA-911 national data. Study results give us more knowledge and specific information
3
than ever before about what factors influence the achievement of competitive
employment for consumers who are also SSDI beneficiaries at application. We
examined a wide range of factors, from individual characteristics such as demographic,
disability, socioeconomic, work history, and a complete list of VR services, to state-level
factors such as state unemployment rate and VR agency structure type. Such statelevel
factors capture influences on outcomes from the context in which the VR process
takes place. Also, the third study goes beyond competitive employment to look at
factors influencing achievement of high closure earnings (above SGA) for consumers
who are SSDI beneficiaries at application. Findings from all three studies are used in
this document as a basis to develop recommendations for practice and agency policy
relevant to working with consumers who are SSDI beneficiaries. Inputs from VR service
delivery professionals also helped shape our recommendations.
A statistical simulation was performed to com pare four least-squares methods of factor analysis on datasets comprising dichotomous variables. In put matrices were: (1) phi correlation coefficients between the observed variables, (2) tetrachoric correlations estimated from bivariate tables of the observed variables, (3) tetrachoric correlations esti mated on the basis of the latent continuous nor mal response variables underlying the observed variables (using LISCOMP with a weighted least- squares factor extraction), or (4) correlations be tween the latent response variables underlying the observed variables based on a variant of latent trait theory (using NOHARM). The simulations were studied under varying sample sizes, threshold values, and population loadings of a factor model. Factor extraction was performed, and a measure of deviation between the population and estimated factor loadings was used as an index of fit. The more sophisticated and less readily available third and fourth methods were not found to be marked ly superior to the first two methods, even for high ly skewed data with small sample sizes. Further simulations were performed to demonstrate the sta bility of the results.
Background
Obtaining and maintaining suitable employment can be a significant challenge for people with multiple sclerosis (MS).
Objective
The objective of this article is to identify what vocational rehabilitation (VR) services helped MS clients obtain and maintain employment, after controlling for the effect of demographic covariates and disability-related government benefits.
Methods
We retrieved data from the Rehabilitation Services Administration (RSA) 911 database in the fiscal year (FY) 2009, and used VR services as predictors to predict employment outcomes of people with MS by hierarchical logistic regression.
Results
A total of 924 out of 1920 MS clients (48.1%) were successfully employed after receiving VR services. Logistic regression analysis results indicated that cash benefits (OR =0.51, p < 0.001) and public medical benefits (OR =0.76, p < 0.01) were negatively associated with employment outcomes, whereas counseling and guidance (OR = 1.68, p < 0.001), job placement assistance (OR = 2.43, p < 0.001), on-the-job supports (OR = 1.62, p < 0.01), maintenance services (OR = 1.59, p < 0.01), and assistive technology services (OR =2.09, p < 0.001) were significant predictors of positive employment outcomes.
Conclusion
VR services were found to be associated with employment status. MS patients experiencing problems obtaining or maintaining employment should be encouraged to pursue services from state VR agencies.
The study investigates the relationship between type of rehabilitation service provided and rehabilitation outcome for individuals who receive Supplemental Disability Income or Social Security Disability Income. In addition, four demographic variables of race, gender, age, and education were examined. Results indicate that job placement, on-the-job training, restoration, miscellaneous training, college or university training, and other services (not otherwise classified) contributed to the explanatory value of the model. The provision of job placement services was found to be of particular importance. Findings are consistent with other studies and indicate the need for provision of job placement services to individuals under the Ticket to Work program implemented by the Social Security Administration.
The purpose of this study was to investigate the relationships among demographics and competitive employment outcomes of vocational rehabilitation consumers with blindness or visual impairments. Using a sample from the RSA-911 data file from fiscal year 2006, relationships were examined among 20 consumer demographic variables related to competitive employment outcomes. The methodology, results, limitations of the study, and implications for practice and future research are discussed.
Introduction
Given the low rate of closure of cases for employment, the study presented here analyzed the characteristics of consumers and services that predict competitive employment for youths with visual impairments who are making the transition from secondary education to employment in the vocation rehabilitation program.
Methods
Using data from the Rehabilitation Services Administration on 2,282 consumers aged 22 or younger whose cases were closed after they received services, we conducted descriptive and logistic regression analyses to determine which client and service factors predicted competitive employment.
Results
Gender; race; education; disability; the severity of visual impairment, receipt of Supplemental Security Income, earnings at the time of application, which are indicative of early work experiences; and four of five service clusters were significantly related to employment outcomes.
Discussion
This research provided new knowledge regarding influences, “risk factors,” and predictors of competitive employment—what works—for youths with visual impairments.
Implications for practitioners
We make recommendations for the provision of vocational rehabilitation services, transition programs, policy regarding groups “at-risk” for poor employment outcomes, and future research.
Introduction
Given mutual concerns of vocational rehabilitation and the Social Security Administration, our purpose was to evaluate the effect of current individual and economic factors on competitive employment for Social Security Disability Insurance (SSDI) beneficiaries with visual impairments in vocational rehabilitation.
Methods
Using fiscal year 2010 RSA-911 data on 4,478 SSDI beneficiaries whose vocational rehabilitation services had concluded, we conducted descriptive and multilevel analyses to determine which client and state or agency factors predicted competitive employment.
Results
Unemployment rate, gender, age, race, disability, severity of visual impairment, education, prior earnings, SSDI amount, and interactive effects of agency structure were significantly related to competitive employment.
Discussion
This research provided new knowledge of state or agency influences, risk factors, advantages, and compensatory effects of services in blind agencies, and underscored the importance of prior work experience in achieving competitive employment for SSDI-beneficiary consumers.
Implications for practitioners
Recommendations related to vocational rehabilitation services to SSDI beneficiaries, policy regarding agency structure, and future research are made.
This study investigated the variables that are associated with competitive employment outcomes for blind and visually impaired vocational rehabilitation (VR) consumers. Utilizing logistic regression, a model that included nine demographic and personal characteristics of consumers and two service-related variables was tested. Findings differ from previous research in this area, with only four variables having a significant association with successful employment: (a) receiving education as a service resulting in an educational certificate or degree, (b) having worked since disability began, (c) reason for applying to VR related to obtaining a job, and (d) the relationship between the counselor and the consumer being rated as high quality.
The purpose of this study was to identify factors that predict employment for transition-age youth with visual impairments. Logistic regression was utilized to predict employment at two levels. Significant variables were early and recent work experiences, completion of a postsecondary program, transportation difficulty, independent travel skills, and social skills.
This article examines factors that influence employment and earnings growth for Supplemental Security Income (SSI) beneficiaries who have participated in the Vocational Rehabilitation (VR) program. Using hierarchical linear and nonlinear modeling (HLM), the authors examined the employment status of these individuals 2 years after exiting the VR program by using state-level economic and VR agency factors, as well as such individual-level factors as demographics, disabilities, and service types. HLM also was used to examine earnings growth among SSI beneficiaries who sustained employment for 5 years after exiting VR. Findings showed that SSI participants with mental retardation exhibited the highest odds of employment among other disability groups 2 years after exiting the VR program. College or university training and job placement services decreased the odds of employment, whereas supported employment demonstrated increased odds. For SSI participants with sustained employment, African American VR consumers showed higher earnings when compared to other race groups. Among selected VR services, only college or university training was positively associated with earnings growth over time. The authors discuss these and other state-level findings in the context of prior and future research, practice, and policies.
This study analyzed the 1996 Rehabilitation Services Administration's (RSA) 911 case service database to determine the characteristics of 59,624 transition-age Supplemental Security Income (SSI) program participants and nonparticipants who exited a vocational rehabilitation program with employment outcomes. Analyses focused on vocational rehabilitation closure statuses, major disabling conditions, earnings and benefits, and services and training received. Findings indicated that SSI participants were just as likely to achieve employment outcomes as SSI nonparticipants. Transition-age SSI participants worked fewer hours and earned less than their nonparticipant counterparts, and employed SSI participants who exited the vocational rehabilitation program were most often persons with mental retardation who continued to receive public assistance income while working. These findings and issues are discussed in terms of policies that emphasize increased work and earnings through the use of SSI work incentives and the provision of timely, consumer-oriented services through the vocational rehabilitation program.
This article is the second in a series of articles that use data from the New Beneficiary Followup survey to analyze the work efforts of the Social Security Administration's Disability Insurance beneficiaries. Survival analysis techniques are used to determine the effect of vocational rehabilitation efforts and work incentive program provisions on actual work outcomes. The findings indicate that the demographic variables of age, gender, race, education, and marital status affect the tendency to return to work in the expected way. The results suggest a possible disincentive effect may be built into certain work incentive provisions of the program. The encouraging news is that the vocational rehabilitation efforts seem to have a positive effect on the tendency to return to work. Physical therapy, vocational training, general education, and job placement efforts all seem to increase the tendency to go back to work.
HLM 7.0 Hierarchical linear and non-linear modeling [Computer software
- W Raudenbushs
- Bryka
- T Congdonr
A report from the National Center for the Study of Postsecondary Educational Supports
- A Stoddenr
- Dowrickp
- Gilmores
- M Gallowayl
Annual Estimates of the Population for the United States, Regions, States
- Puerto Rico