Employment Outcomes for Individuals with Multiple Sclerosis: 2011-2013

By Inge, Katherine J.; Cimera, Rob E. et al. | The Journal of Rehabilitation, October-December 2016 | Go to article overview

Employment Outcomes for Individuals with Multiple Sclerosis: 2011-2013


Inge, Katherine J., Cimera, Rob E., Rumrill, Phillip D., Jr., Revell, William G., The Journal of Rehabilitation


More than 2.3 million people in the world are estimated to have multiple sclerosis (MS), with approximately 400,000 of these individuals living in the United States (National Multiple Sclerosis Society, 2015). The average age range of clinical onset of MS is 30-33, and the average age of diagnosis is 37 (Statistics Brain Research Institute, 2015). Because of the wide range of symptoms and the unpredictable nature of MS, the disability has a significant impact on employment. Although 98% of people with MS have employment histories and 82% were still working at the time of diagnosis (Roessler, Rumrill, Li, & Leslie, 2015), the vast majority of workers with MS were no longer working 5 years post diagnosis. Reasons noted why individuals with MS leave the work force include, for example, the physiological effects of the illness, including fatigue, ambulation difficulties, and compromised accessibility of their home environments and/or their ability to travel independently (Rumrill, Roessler, Li, Daly, & Leslie, 2015). The current rate of unemployment for people with MS in the United States is between 55% and 70% (Rumrill et al, 2015), resulting in a disproportionately high level of unemployment among a population who are qualified and experienced workers.

Early on post-diagnosis, fatigue, anxiety, and depression impact the ability of individuals with MS to work. Furthermore, the unpredictable pattern of relapses related to the course of the disease can lead to a lack of confidence in abilities (Roessler & Rumrill, 2003; Rumrill, Roessler, McMahon, Hennessey, & Neath, 2007). As MS progresses, physical symptoms are strong predicators of job loss (Rumrill, 2006). These include mobility limitations, physical stamina, fatigue, poor dexterity, visual impairment, cognitive limitations, urinary and fecal frequency and urgency, and dysarthria (Roessler & Rumrill, 2003, Rumrill et al., 2007). Those who report cognitive dysfunction were four times more likely to be unemployed than those who did not (Roessler et al., 2004).

Vocational Rehabilitation (VR) through the use of the federal and state vocational rehabilitation program is one option for obtaining the needed supports that can lead to successful competitive employment outcomes. However, Rumrill, Fraser, and Johnson (2013) found that only 26.8% of the individuals with MS in its study sample contacted their state VR agency for assistance. Reasons proposed by the authors for individuals with MS not contacting VR included confidence in the person's ability to handle the situation alone and/ or a lack of knowledge about the state/federal VR program and its potential services.

VR Agencies funded by the Rehabilitation Act of 1973, as amended, submit annually to the Federal Rehabilitation Services Administration (RSA) the RSA911 Closure Report (1). The 911 Report contains information on individuals who terminated VR services during a specific Fiscal Year. Termination of VR Services is reported as one of following Case Closure codes:

* Status 08: An individual was found to be not eligible for services.

* Status 30: Unsuccessful, case closed after eligibility determination but before implementing an IPE.

* Status 28: Unsuccessful, case closed after implementing an Individualized Plan for Employment (IPE) without achieving an employment outcome.

* Status 26: Successful rehabilitation, employment outcome achieved.

The requirements for a VR participant to be closed as a successful rehabilitation with the employment outcome achieved are: (1) the employment outcome is consistent with the employment goal described in the person's Individual Plan for Employment (IPE); (2) the individual has maintained the employment outcome for an appropriate period of time, but not less than 90 days, necessary to ensure the stability of the employment outcome, and the individual no longer needs VR services; (3) the individual and his or her VR counselor consider the employment outcome to be satisfactory and that the person is performing well in employment; and (4) the individual knows about the availability of post-employment services (Office of Special Education and Rehabilitation Services, 2012). …

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Employment Outcomes for Individuals with Multiple Sclerosis: 2011-2013
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