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Vocational Rehabilitation

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ESRD Network 18 strives to promote optimal care for individuals with End-Stage Renal Disease.
Optimal care not only includes safe, high quality care, but must also include efforts to improve
patient independence, quality of life, and rehabilitation. The CMS Conditions for Coverage for
ESRD Facilities require facilities to assist patients with an individualized vocational rehabilitation
(VR) plan. Efforts to promote vocational rehabilitation, including patients with job retention strategies,
making referrals to job training, and employment counseling/placement services are important interventions
in trying to improve the social functioning of patients; who are in their prime working years.

What is Vocational Rehabilitation?
Having chronic kidney disease has changed your life, but there are things you can do to reduce the impact on
your lifestyle and income. You can feel well enough to work on dialysis. With the exception of heavy physical
labor, most dialysis patients are capable of performing the specific job tasks they did before they started
dialysis. If you are on dialysis, you are eligible for Vocational Rehabilitation (VR) counseling. VR can assist with:

  • Evaluation of your areas of interest and work history
  • Education and training
  • Independent living services (home modifications if related to employment or services for older or blind people to live independently at home)

What can I expect when I go to a VR office for employment counseling and placement services?

  • Some VR offices have a group orientation session. During orientation, you will be provided with a copy of their handbook of services.
  • You will be asked to fill out a VR application. Having a plan for the type of work you want to do can make you a more attractive candidate.
  • After the application is received by VR, you will be contacted and assigned to a counselor.
  • Be prepared to educate your counselor about kidney disease and treatment, how it affects your ability to work, why you need VR help to get and keep a job, and what you may need in a job to fit with dialysis.
  • Keep in regular contact with your VR counselor, and be persistent throughout the process.
  • The counselor will determine if you are eligible. Many factors can determine eligibility, such as:
    • Whether you receive Social Security disability benefits
    • How motivated you are to work
    • The physician’s release to work
  • You may be placed on a waiting list for services after eligibility is determined. If so, priorities for who is
    served first are based on “order of selection” and date of application. If the wait is long, talk to your
    dialysis social worker about using an employment network (EN) instead.
  • Once you are taken off of the wait list, an individualized written plan for services will be developed.
  • You can get VR services to get a job. When your VR case is closed, you can get support from an EN to keep your job.
  • Tell your dialysis social worker how the VR process is going, and if you need help.

What steps should I take next?

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