The when and why of a vocational assessment

Gabriella Kourie explains when and why a vocational assessment would be needed after cancer treatment.

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Within the scope of occupational therapy, there is a specialised field called vocational rehabilitation (voc rehab). The purpose is to help individuals return to their line of work after an illness or injury. 

The role of the occupational therapist (OT) is to facilitate the patient’s abilities to cope with the physical and psychosocial demands of their job. In doing so, the OT ensures that the patient returns to work in the most functional form without barriers in the workplace (physical and/or social).

In the specific context of a cancer diagnosis, vocational rehabilitation can be a powerful tool in assisting patients to regain their full quality of life. 

However, this specialised line of occupational therapy can also be used to motivate for and achieve partial or full disability for a patient, based on their stage and prognosis of the disease.

The ultimate goal

Full participation in life is the ultimate goal of rehabilitation. For most adults, work is one of the most important areas of occupation as it usually makes up most of their functional daily lives. 

It’s the occupational area where other important functions stem, such as personal management (grooming for a day in the office), survival skills (being able to save and spend accordingly based on income) and social participation (daily interactions with superiors, colleagues and/or employees).

A recent study, conducted in 2020, indicated that more than a third of patients diagnosed with cancer in America were between the ages of 20-59.¹ This is the average age group of working individuals. The need to get back to work during or after oncology treatment is a priority for many patients.

However, there may be some barriers that hinder a patient from reintegrating into their workplace. These barriers may include physical and psychosocial fatigue; the inability to carry out work tasks at the normal pace; and in severe cases, chemo brain can permanently hinder a patient’s ability to participate in the expected tasks at work.

The voc rehab process

The process usually follows a step-by-step format, however, it can be adjusted based on the patient’s needs. An oncology patient can be referred for an assessment and evaluation at any point of their treatment journey. 

It’s most common that patients are sent for a vocational rehabilitation assessment once they have completed their chemotherapy regimen. It’s at this time where chemo brain may be most prevalent, or in other cases, patients who have taken time off work, start to plan their return. 

It may be deemed that the patient may need an extended time away from work, or to undergo some work hardening activities and exercises. This may include simulating work tasks for a patient to attempt and adjust accordingly if they can’t function independently. 

Once the assessment and evaluation are complete, a comprehensive report is drafted and sent to the patient as well as the employer. It’s then used to motivate Reasonable Accommodation; this is adaptations made in the workplace, physical or intangible, to help assist the patient’s return to work to be as smooth as possible. 

Once this has been implemented, the OT will do a follow-up to assess the effectivity of the patient and to review if any assistance in the workplace needs to be adjusted or removed.

The value

There is ample value in doing a vocational rehabilitation assessment and evaluation, especially if a patient is struggling to cope with previously easily achievable work tasks and expectations. This can be distressing for them and may affect their confidence in returning to work. 

The need for a vocational rehabilitation assessment can be discussed with your treating oncology physician or surgeon to determine if you are a candidate to undergo the assessment and evaluation. 

Vocational assessments are usually reserved for patients who have chronic psychosocial and/or physical impairments. However, it shouldn’t be overlooked as a tool that can be used to help oncology patients regain independence and full function.

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Reference

1. Cancer Today. Estimated number of new cases in 2020, all cancers, both sexes, ages 20–59 (World). World Health Organization. 2020. https://gco.iarc.fr/. Accessed 19 Nov 2021.

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