here - ABVE

Transcription

here - ABVE

ABVE 2011 Conference Exhibitors
SkillTRAN, LLC
3910 S. Union Ct.
Spokane Valley, WA 99206
(800) 827-2182 [Sales] - Pacific Time Zone
(888) 926-2611 [Fax]
(509) 927-8195 [Spokane]
Jeff Truthan, MS, CVE – President
jtruthan@skilltran.com
www.skilltran.com
University of Florida
Department of Behavioral Science and Community Health
HPNP, 101 S. Newell Drive Room 4181
PO Box 100175
Gainesville, FL 32610-0175
Programs offered:
Life Care Planning and Medicare Set Aside Certificate Programs
Forensic Vocational Rehabilitation Certificate Program (Coming Soon!)
Contact information:
Amanda Glynn (Program Coordinator)
Phone # 352-273-6491
Email ahusk@ufl.edu
American Board of
Vocational Experts
WELCOME TO THE 2011 ABVE CONFERENCE!
We’re glad you are here! The outstanding educational sessions
over the next three days give you access to the industry leaders
with exceptional insights. Expect to walk away with tools and
resources to immediately improve your forensic vocational
practices.
From the desk of:
Larry L. Sinsabaugh, PhD
President 2009-2011
Sinsabaugh Consulting Services, PC
10315 Attems Way
Glen Allen, VA 23060
E-mail
larry@sinsabaughconsulting.com
The ABVE Conference offers you the opportunity to make new
connections and reacquaint yourself with colleagues you
haven’t seen in a while. Don’t neglect the President’s Welcome
Reception on Friday from 6:00 – 7:30 pm. Take this time, as
well as the Membership Luncheon on Saturday, to engage in
lively discussions and tap into the wealth of experience of your
fellow vocational experts.
On behalf of the ABVE Board of Directors, we are so happy to
have you join us for an outstanding weekend of learning and
networking at the premier event in the field of vocational
testimony.
Thank you to the
2011 Conference Planning Committee
ABVE Headquarters
3540 Soquel Ave.,
Suite A
Santa Cruz, CA 95062
PH: 831-464-4890
Fax: 831-576-1417
Email: abve@abve.net
Website: www.abve.net
Howard Caston, Conference Chair
Gray Broughton
Chad Duncan
Alberto Felix
Estelle Hutchinson
Rick Robinson
David San Filippo
TABLE OF CONTENTS
CONFERENCE PROGRAM
Page
Schedule-at-a-Glance
4
Session Descriptions
5-8
2010-2011 Board of Directors
9
Continuing Education Credits Instructions
10
Continuing Education Conference Attendance Verification Form (Yellow)
11
Conference Evaluation Form (Please turn into registration desk – thanks!)
13
CONFERENCE SESSION HANDOUTS
The Technological World of Prosthetics
Chad Duncan Ph.D.
Assessing Medical Aspects of Rehabilitation with the Earning Capacity
Assessment Form-2 (ECAF-2)
Michael Shahnasarian Ph.D., CRC, CVE, CLCP, LP,
NCDA Fellow, IALCP Fellow
Killer Cures: The Untoward Effects of Treatment and Disability
Linda Stein MBA, Ed.M., CRC, CCM
Forensic Testimony for Psychiatric Conditions Using Social Security
Format; RFC, GAF, Malingering, Consulting/Treatment Dichotomy
Charles Cohen Ph.D., CRC, ABVE/D
Vertigo: The Hidden Disability
David San Filippo Ph.D.
Social Security’s OIS Development: Get Involved!
Bonnie Martindale MA, MCDD, CRC, CEAS, CPDM, CRP
Report Writing Peer Review Workshop
Michael Graham Ed.D., ABVE/D
Use of VE Testimony in Social Security Disability HearingsVEs are not just reciters of the DOT!
Samuel Edelmann M.Ed., ABVE/D
Developing Resources for International Life Care Planning
Penelope Carragonne Ph.D., CLCP
Testimony in Depositions and Trials
Cynthia Grimley MS, CRC, CCM, ABVE/D
The Economic Recession and Vocational Assessments
John Berg M.Ed., CRC, CDMS, ABVE/D
Jeff Truthan, MS, CVE
Multicultural Medical & Vocational Case Management
Barbara Berndt M.Ed., CRC, CDMS, CCM, ABVE/D
17
19
33
51
71
73
81
99
101
109
129
153
ABVE 2011 Conference Schedule
Thursday,March24,2011
8:30am12:00pm
1:00pm4:00pm
1:00pm5:30pm
ForumEast4
ForumEast4
LegacySouth1
KnowledgeEnhancementSeminar(KES)
NationalCertificationExamination
BoardMeeting
7:30am5:30pm
7:30am8:30am
Mezzanine2ndFloor
FoyerLegacyBallroom
RegistrationDesk
ContinentalBreakfast
8:30am11:45am
LegacyNorth1
LegacyNorth2
ConcurrentPreConferenceWorkshops 1.SocialSecurityAdministrationMockHearing
2.HistoricalReviewoftheEvolutionof
RehabilitationForensicConsulting
10:00am10:15am
11:45am1:00pm
1:00pm1:15pm
1:15pm3:15pm
3:15pm3:30pm
3:30pm4:30pm
4:30pm5:30pm
FoyerLegacyBallroom
LegacyNorth
LegacyNorth
FoyerLegacyBallroom
LegacyNorth
LegacyNorth
Poolside
Break
LunchOnYourOwn
ConferenceOpeningandWelcome
TheTechnologicalWorldofProsthetics
Break
AssessingMedicalAspectsofRehabilitationwith
theEarningCapacityAssessmentForm2
KillerCures:TheUntowardEffectsofTreatmentand
Disability
President'sWelcomeReception
7:00am5:30pm
7:00am8:00am
8:00am9:15am
9:15am10:30am
10:30am10:45am
10:45am12:00pm
12:00pm1:15pm
Mezzanine2ndFloor
FoyerLegacyBallroom
LegacyNorth
LegacyNorth
FoyerLegacyBallroom
LegacyNorth
Legends1(1stFloor)
RegistrationDesk
ForensicTestimonyforPsychiatricConditionsUsing
SocialSecurityFormat
TheVocationalImpactofChronicVertigo
Break
OIDAPUpdateandQ&A
AnnualBusinessMeeting&AwardsLuncheon
1:15pm2:15pm
LegacyNorth1
LegacyNorth2
ConcurrentSessions
ReportWritingPeerReviewWorkshop(PartOne)
UseofVETestimonyinSocialSecurityDisabilityHearings
2:30pm3:30pm
3:30pm3:45pm
LegacyNorth1
LegacyNorth2
FoyerLegacyBallroom
ConcurrentSessions
ReportWritingPeerReviewWorkshop(PartTwo)
EmployerValidationofAcceptableAbsenteeism
RatesinForensicandSocialSecurityVenues
Break
3:45pm5:30pm
LegacyNorth1
LegacyNorth2
ConcurrentSessions
DevelopingResourcesforInternationalLifeCarePlanning
TestimonyinDepositionsandTrials
Mezzanine2ndFloor
FoyerLegacyBallroom
LegacyNorth
FoyerLegacyBallroom
LegacyNorth
LegacyNorth
LegacyNorth
RegistrationDesk
TheEconomicRecessionandVocationalAssessments
Break
TheNewAmericanEmployeeMeltingPot:What'sCooking?
MulticulturalMedical&VocationalCaseManagement
ConferenceWrapUp
Friday,March25,2011
6:00pm7:30pm
Saturday,March26,2011
Sunday,March27,2011
7:30am5:30pm
7:30am8:30am
8:30am10:00am
10:00am10:15am
10:15am11:15am
11:15am12:15pm
12:15pm12:30pm
4
Room Locations are listed on the Schedule-a
at-a
a-G
Glance
Friday, M arch 2 5, 2 011
8:30am - 11:45am
# of CEUs Available
ABVE
4.5
All Other Bodies
3.0
Pre-Conference Workshop I
Social Security Administration Mock Hearing with ALJ and Plaintiff Attorney
David San Filippo Ph.D., Judge James Ciaravino, and Paul Morgan
This presentation will provide participants insight on the workings of a Social Security
disability hearing and the value of vocational testimony and medical evidence in the
adjudication of Social Security disability cases. An Administrative Law Judge and an
Attorney will hear a disability case and call upon the alleged disabled worker and the
vocational expert to hear testimony regarding the case. The mock hearing will be
followed by a question and answer session. Attendees will receive a complimentary copy
of The Vocational Expert: Revised and Updated published by Elliott & Fitzpatrick.
Pre-Conference Workshop II
# of CEUs Available
ABVE
4.5
All Other Bodies
3.0
3.0
Conference Opening
Larry Sinsabaugh, ABVE President, and Howard Caston, Conference Chairman
1:15pm - 3:15pm
Alistair Gibson BSc, (Hons O&P), CPO, LPO, Hangar Prosthetics & Orthotics, Inc.
Chad Duncan Ph.D., Rehabilitation Services, Alabama State University
Davie Medelsohn, Touch Bionics
All Other Bodies
2.0
3:30pm - 4:30pm
# of CEUs Available
ABVE
1.5
All Other Bodies
1.0
4:30pm - 5:30pm
# of CEUs Available
ABVE
1.5
This session will review and discuss several historical landmarks that impacted the
development and evolution of vocational rehabilitation consulting in the forensic
arena. The presentation will include a review of selected events, discussion of
pertinent legal cases, and selected “war stories” to illustrate how the profession
arrived at its current state. Audience will be invited to share relevant experiences as well.
Attendees will receive printed resource material from Elliott & Fitzpatrick.
1:00pm - 1:15pm
# of CEUs Available
ABVE
A Historical Review of the Evolution of Medical Aspects of Disability in
Rehabilitation Forensic Consulting: How We Got to Where We Are Today
Timothy Field Ph.D.
All Other Bodies
1.0
Are you tired of people just presenting? Come to this exciting presentation that
combines didactic and hands-on styles of education. This presentation will cover the current
and upcoming technologies in the field of Prosthetics (artificial limbs). You will have the
chance to see actual users and hear testimonies on these revolutionary advances in
prosthetics.
Assessing Medical Aspects of Rehabilitation with the Earning Capacity
Assessment Form-2 (ECAF-2)
Michael Shahnasarian Ph.D., CRC, CVE, CLCP, LP, NCDA Fellow, IALCP Fellow
The Earning Capacity Assessment Form (ECAF–2) is the only commercially available,
validated instrument to assess claims of loss of earning capacity. Its items include considerations of key medical aspects of rehabilitation, including ability to apply prior skills, need and
capacity for retraining, and prognosis. Your attendance at this program will enable you to
apply state-of-the-art analyses and science when you formulate and present your expert
opinions.
Killer Cures: The Untoward Effects of Treatment and Disability
Linda A. Stein MBA, Ed.M., CRC, CCM
Killer Cures is more than an oxymoron.
This presentation will provide an
understanding of how a comprehensive and collaborative approach is required for true
rehabilitative sustainability to take place. Case studies will be shared to illustrate the dilemmas clinicians face. The challenges of treatment which does not cause untoward effects will
be discussed.
Join your colleagues at the President’s Welcome Reception poolside from 6:00 - 7:30pm
5
r ence f or a dditional h andouts.
Visit w ww.ABVE.net a fter t he c onfer
onference
Saturday, M arch 2 6, 2 011
8:00am - 9:15am
# of CEUs Available
ABVE
1.875
All Other Bodies
1.25
9:15am - 10:30am
# of CEUs Available
ABVE
1.875
All Other Bodies
1.25
10:45am - 12:00pm
# of CEUs Available
ABVE
All Other Bodies
1.25
1.875
Forensic Testimony for Psychiatric Conditions Using Social Security Format;
RFC, GAF, Malingering, Consulting/Treatment Dichotomy
Charles Cohen Ph.D., CRC, ABVE/D
The Social Security matrix for evaluating a person’s claiming psychiatric disability will be
reviewed. Emphasis will be placed on how this model can be applied to return to work
strategies and how this model can be used in other forensic settings. Related issues include;
diagnosis vs. residual functional capacity, treating vs. consultative examinations, the Global
Assessment of Functioning (GAF) scale, somatization vs. malingering, primary vs. secondary
diagnosis, effects of medications and non-compliance with treatment.
The Vocational Impact of Chronic Vertigo
David San Filippo Ph.D.
Chronic vertigo impacts many workers ability to continue to perform his/her
occupation upon its onset. Vertigo can be initially caused by an accident, illness or
spontaneously, without a specific cause. The impact on many workers is their inability to
perform the type of work they performed prior to being affected by vertigo. This has a
personal and economic impact on the worker with vertigo and a possible economic and/or
legal impact on some employers.
Bonnie Martindale MA, MCDD, CRC, CEAS, CPDM, CRP
Let this session bring you up to date on the recommendations from the Occupational
Information Development Advisory Panel to the Social Security Administration. Learn about
research already underway, work measures under construction, and how you can participate.
1:15pm - 2:15pm Concurrent Sessions
TRACK ONE Report Writing Peer Review Workshop (Part One)
# of CEUs Available
ABVE
1.5
All Other Bodies
1.0
TRACK TWO
# of CEUs Available
ABVE
All Other Bodies
1.0
1.5
2:30pm - 3:30pm
TRACK ONE
# of CEUs Available
ABVE
All Other Bodies
1.0
1.5
Individuals who expect to participate in this session are asked when they register
online for the conference to provide redacted sample reports to be used during this
program. Some of these reports will be presented to the participants for discussion and
critique. This program will be divided into into five basic components: (1) a
summary of the critical aspects of a report, (2) audience participation in reviewing
sample reports, (3) critiques and presentations by participants, (4) question and answer
discussions on the content of this session , and (5) a general summary regarding the
content and format of an admissible forensic report. It is expected that there will be
lively discussions concerning the pros and cons of the content of a forensic report.
Use of VE Testimony in Social Security Disability Hearings -VEs are not just
reciters of the DOT!
Samuel Edelmann M.Ed., ABVE/D and Cynthia Berger, Attorney
While the DOT, the bible of jobs, has not been updated in almost 20 years, VE
testimony has evolved. VEs must be ready to use other information to testify
credibly. What will judges and attorneys accept? An ODAR Judge, claimants
attorney and VE will discuss issues regarding the use of VEs. Ample discussion time will be
allotted for audience questions and input.
Concurrent Sessions
Report Writing Peer Review Workshop (Part Two)
Workshop continued. Participants should attend both parts one and two.
Breaks & Refreshments 10:30am and 3:30pm
Membership Luncheon 12:00pm
6
e nce f or a dditional h andouts
Visit w ww.ABVE.net a fter t he c onfere
onference
Saturday, M arch 2 6, 2 011
2:30pm - 3:30pm
TRACK TWO
# of CEUs Available
ABVE
All Other Bodies
1.0
1.5
Concurrent Sessions - Continued
Employer Validation of Acceptable Absenteeism Rates in Forensic and
Social Security Venues
Irmo Marini Ph.D., CRC, CLCP, FVE, Richard Miller MS, CRC, Alinka Del Castillo,
and Elizabeth Palacios MA
Vocational Experts testifying in SSA cases are often asked by claimant's representative as to
what is an acceptable missed work absenteeism rate each month. Vocational experts have
been debating this issue with no real empirical data from human resource personnel as to how
many days per month would be considered acceptable to miss work without an employee
losing their job. In the present study, researchers surveyed over 1,000 human resource
personnel from a variety of businesses across the country, essentially focusing on common jobs
we refer to in testimony. Findings will assist VEs in empirically supporting their opinions.
3:45pm - 5:30pm
TRACK ONE
# of CEUs Available
ABVE
All Other Bodies
1.75
2.625
TRACK TWO
# of CEUs Available
ABVE
All Other Bodies
1.75
2.625
ETHICS
# of CEU’s Available
ABVE
All Other Bodies
1.0 potential
1.5
Concurrent Sessions
Penelope Caragonne Ph.D., CLCP and Keith Sofka, ATP
Learn how and when to produce an international Life Care Plan. Discover how to find the
resources and costs from another country. Find answers to the following: How is this
disability managed in this country? What are the equivalent services and are they
available? Who can help with research and contacts when I don’t speak the language?
What additional factors must be considered to effectively convert an LCP for use in
another country?
Testimony in Depositions and Trials: For the Expert With Little Testifying
Experience or Those Veterans Who Still Want To Learn
Cynthia Grimley MS, CRC, CCM, ABVE/D, Larry Sinsabaugh Ph.D., ABVE/D and
E. Davis Martin Ed.D., ABVE/D
Presenters will use didactic and experiential techniques to emphasize core concepts and
the ethics (i.e., ABVE, ACA, CRCC, CDMS, NBCC Codes of Ethics) associated with the
delivery of effective testimony to a wide variety of legal settings, except SSA hearings.
Registrants will observe and will be urged to participate in role-plays and share
observations highlighting core concepts demonstrated by presenters, all who have many
years experience testifying. Core concepts will come from Kolb Model of Experiential
Learning and two Elliott & Fitzpatrick publications: The Vocational Expert: Revised and
Updated and Admissible Testimony A Content Analysis of Selected Cases Involving
Vocational Experts with a Revised model for Developing Opinion.
Networking O pportunities
President’s Welcome Reception - Friday, March 25, 2011 6:00 - 7:30pm
Mingle with old friends and make new ones at the opening evening reception. Take this time to engage in lively
discussions and tap into the wealth of experience of your fellow vocational experts.
Annual Business Meeting and Awards Luncheon - Saturday, March 26, 2011 12:00 - 1:15pm
The luncheon is a chance to network with your colleagues and hear from the ABVE Board of Directors about association finances, policies and current events. Members will be invited to ratify the Board of Director's vote for the new
President-Elect. A portion of the agenda is reserved as an open forum for ABVE Members. The David S. Frank
Lifetime Achievement Award, the Scott E. Streater Educational Award and Presidential Citations will be presented.
Breakfast & Breaks (see schedule pg. 4 for days / times)
Greet the day and other conference attendees at the continental breakfast each morning. Jump start the day's
session topics with conversations about your case experiences, innovations in the field and tools of the trade. Each
day we will also have morning and afternoon breaks for you to continue discussions or view products and services
of our featured vendors.
7
e nce f or a dditional h andouts.
Visit w ww.ABVE.net a fter t he c onfere
onference
Sunday, M arch 2 7, 2 010
8:30am - 10:00am
# of CEUs Available
ABVE
All Other Bodies
1.5
2.25
The Economic Recession and Vocational Assessments: How Current
Economic Times are Forcing Us to Rethink Our Business
John Berg M.Ed., CRC, CDMS, ABVE/D, Rick Robinson M.Ed., MBA, ABVE/D,
Jeff Truthan MS, CVE and Devin Lessne MA, MS, CRC, CDMS, QRP
Staggering unemployment rates. Job losses across every business sector. Job seekers with
complicating psychological disabilities; depression, anxiety, stress disorder. In today's
economic climate, the business of vocational assessments has changed. During this session,
a panel of vocational experts will discuss ways to help mitigate against the challenging
times. We will discuss how unemployment across the board has impacted labor market
research resources, the presentation of credible data, strategies for tailoring written report,
and other techniques designed to help you navigate these times.
10:15am - 11:15am
# of CEUs Available
ABVE
All Other Bodies
1.0
1.5
ETHICS
11:15am - 12:15pm
# of CEUs Available
ABVE
All Other Bodies
1.0
1.5
ETHICS
12:15pm - 12:30pm
The New American Employee Melting Pot: What’s Cooking?
Alberto Felix MA, CRC, CDMS, CCM, ABVE/F
Minorities (those classified as any race other than non-Hispanic, single race white) will be
the majority in America by 2042. As this suggests, the workplace population will continue
to shift and globalization will place all organizations under fire to increase diversity. As a result of the demographic shift and globalization, Vocational Experts must be aware of the
trends and better understand tomorrow’s clients. As leaders in the field of forensics, we
need to assess and analyze our stereotypes before performing comprehensive assessments
on individuals of different cultures and subcultures. This will solidify our credibility. This
program will no doubt assist the attendee in assessing their predispositions to stereotyping
and better understand the principles and guidelines of the various certifying bodies.
Barbara Berndt M.Ed., CRC, CDMS, CCM, ABVE/D
As we expand our professional practices, the world seems closer than ever! If you have
clients from different cultures, continents and with different value systems, this is the presentation you will wish to attend. Ethical guidelines now require us to understand, evaluate
and implement appropriate case management to diverse cultures. Develop your expertise
and diversity!
Conference Wrap Up
Remember Y our C EUs!
Important Guidelines
Session Evaluation Forms will be distributed as you enter each session.
At the end of each session, complete and sign a session evaluation form.
Have a session monitor stamp each session evaluation form.
Have a session monitor stamp your Attendance Verification Form for each session. This yellow form is
located in your program book and must be stamped on both sides of the tear out form for each session
attended.
In order to receive full credit, all participants must submit their entire packet with Attendance Verification
Form and all Session Evaluation forms to the registration desk at the completion of the conference.
These instructions and guidelines apply to those participants seeking continuing education credit for
ABVE, CRC, CDMS, CCM, CVE, CLCP, APA, NBCC, RRP, RCSS, and RVP. Make sure to mark your
designations for which you would like CEU credit on the yellow Attendance Verification Form.
8
2010-2011 ABVE Board of Directors
President/Publications Chair (2009-2011)
Larry Sinsabaugh
Sinsabaugh Consulting Services PC
10315 Attems Way
Glen Allen, VA 23060
Cell: (804) 874-3704 | Office: (804) 755-7705
Fax: (804) 755-7720
larry@sinsabaughconsulting.com
President Elect (2009-2011)
H. Gray Broughton
Broughton Associates, Inc.
6802 Patterson Avenue
Richmond, Virginia 23226
Cell: (804) 221-4199 | Office: (804) 282-4199
Fax: (804) 285-0540
bai@broughtoninc.com
Past President
Election/Test/CEU Chair (2009-2011)
G. Michael Graham
Graham Consulting Group, Inc.
2723 Crow Canyon Re., Ste. 105
San Ramon, CA 94583
Cell: (925)-413-6053 | Office: (925) 837-7360
Fax: (925) 837-2406
gmgedd@yahoo.com
Secretary (2009-2012)
Cheryl Chandler
Cheryl R. Chandler, M.A., CRC
1713 Tulare St., Ste. 102
Fresno, CA 93721-2528
Office: (559) 248-8200 |
Fax: (559) 408-7498
cheryl@crcexpert.com
Treasurer (2010-2013)
Estelle Hutchinson
Vocational Directions, Inc.
1 Richmond Square, #304N
Providence, RI 02906
Cell: (401)-588-4767 | Office: (401) 383-4069
Fax: (401) 244-7490
erhutchinson@cox.net
Director-at-Large
Conference Chair CEU Co-Chair (2009-2012)
Howard Caston
Caston & Associates
10999 Reed Hartman Hwy
Suite 214
Cincinnati, Ohio 45242
Office: (513) 985-9151 Fax: (513) 985-9156
hcaston@castonassociates.com
Director-at-Large
Communications/Technology Chair
(2010-2013)
John Berg
Vocational Consulting, Inc.
3515 SW Alaska Street
Seattle, WA 98126
Office: (206) 933-8870 Fax: (206) 937-6236
johnberg@nwlink.com
Director-at-Large (2009-2012)
Jayne Barton
Vazquez Vocational Experts, Inc.
3715 San Lorenzo River Road
Ontario, CA 91761
Office: (909) 947-6224 Fax: (909) 947-3925
jbartonvve@verizon.net
Ethics/Membership Chair
Ronald Smolarski
Beacon Rehab
114 Felch St., Ann Arbor, Michigan 48103
Office: (734) 665-8326 Cell: (734) 417-9935
Fax: (734) 665-2584
ron@beaconrehab.com
Certification Chair
Richard Barry Hall
Richard Barry Hall, Inc.
PO Box 1744
Gray, Maine 04039-1744
Office: (207)-657-3510 | Fax: (207)-657-5968
alpaca@maine.rr.com
Journal Editor (Ex Officio) (2009-2011)
E. Davis Martin, Jr.
Auburn University
Dept. Head, Special Ed., Rehab, Counseling/Psych.
2084 Haley Center
Auburn, AL 36849
Office: (334) 844-7676
Fax: (334) 844-7677
martiev@auburn.edu
Executive Director
Glenn Zimmermann
3540 Soquel Ave., Ste. A
Santa Cruz, CA 9506
Office: (831) 464-4890
Fax: (831) 464-4881
glenn@btfenterprises.com
Canadian Advisory Committee (2010-2011 Appointed)
Robert Lychenko
Evergreen Rehabilitation Services
2601 Matheson Blvd East Unit 207
Mississauga, Ontario L4W 5A8 Canada
Office: (905) 624-4255
Fax: (905) 624-8270
evergreenrehab@primus.ca
9
2011 ABVE Conference
March 25-27, 2011 | Orlando, FL
Instructions for Continuing Education Units
1. At the end of each session, complete and sign a Session Evaluation Form.
2. Have a session monitor stamp each session evaluation forms.
3. Have a session monitor stamp your Attendance Verification Form for each session.
This form is located in your program book and must be stamped on both sides of the tearout form for each session attended.
4. Keep ALL of your session evaluation forms and your Attendance Verification form
throughout the entire conference.
5. At the end of the conference, attach the stamped ABVE Headquarters portion of
Attendance Verification Form to all of your session evaluation forms and submit your
packet to the registration desk.
6. Keep the stamped Attendee portion of the Attendance Verification Form for your records.
7. An official Certificate of Completion will be mailed to you within three weeks of the end of
the conference. The certificate will document the number of CEUs earned for each of the
designations you requested on the Attendance Verification Form.
Important Guidelines
x
x
x
x
x
x
Session Evaluation Forms will be distributed as you enter each session.
You will not be given a Session Evaluation Form if you arrive more than 10 minutes late to a
session nor will you receive credit if you leave before its conclusion.
Have your forms stamped at the conclusion of each session.
Forms will not be stamped once you have exited the session.
Unstamped forms will not be awarded credit.
In order to receive full credit, all participants must submit their entire packet with Attendance
Verification Form and all Session Evaluation forms to the registration desk at the completion of
the conference. Accreditation boards will not accept individual forms for individual sessions.
These instructions and guidelines apply to those participants seeking continuing education
credit for ABVE, CRC, CDMS, CCM, CVE, CLCP, CCLCP, APA, NBCC, RRP, RCSS, and RVP.
NBCC: ABVE is recognized by the National Board for Certified Counselors, Inc. to offer continuing education
for national certified counselors. We adhere to NBCC continuing education guidelines.
APA : The American Board of Vocational Experts is approved by the American Psychological Association to
sponsor continuing education for psychologists. ABVE maintains responsibility for this program and its
contents.
Attendee: Submit your Certificate of Completion to CRCC and/or CDMSC at 1699 east Woodfiled Road, Suite
300, Schaumburg, IL. 60173. At least one ORIGINAL of the Certificate of Completion must be included.
CCMC Approved Activity: The course listed above was completed on 03/27/11 and is approved for
18.00CEUs. Sponsor code: CM2337 Approval number: CM2337-A200. To claim these CEUs, log into your
CE Center account at www.ccmcertificaiton.org.
10
American Board of Vocational Experts
2011 CONFERENCE | March 25-27, 2011 | Orlando, FL
2011 CONFERENCE | March 25-27, 2011 | Orlando, FL
ATTENDANCE VERIFICATION FORM
ATTENDANCE VERIFICATION FORM
Attendee Record (duplicate)
ABVE Headquarters Record
______________________________________________
NAME (Please Print)
______________________________________________
NAME (Please Print)
I am requesting CEUs for (check all that apply):
I am requesting CEUs for (check all that apply):
ABVE CRC CDMS CCMC CVE
CLCP/CCLCP RRP RCSS RVP
Verification
NBCC
APA
ABVE CRC CDMS CCMC CVE
CLCP/CCLCP RRP RCSS RVP
Friday, March 25, 2011
Friday, March 25, 2011
8:30 - 11:45 am (Precon #1)
3.0 CEUs (4.5 ABVE)
Social Security Administration Mock Hearing with ALJ and
Plaintiff Attorney
8:30 - 11:45 am (Precon #2)
3.0 CEUs (4.5 ABVE)
A Historical Review of the Evolution of Medical Aspects of
Disability in Rehabilitation Forensic Consulting: How We Got
to Where We Are Today
1:15 - 3:15 pm
2.0 CEUs (3.0 ABVE)
8:30 - 11:45 am (Precon #1)
3.0 CEUs (4.5 ABVE)
Social Security Administration Mock Hearing with ALJ and
Plaintiff Attorney
8:30 - 11:45 am (Precon #2)
3.0 CEUs (4.5 ABVE)
A Historical Review of the Evolution of Medical Aspects of
Disability in Rehabilitation Forensic Consulting: How We Got
to Where We Are Today
1:15 - 3:15 pm
2.0 CEUs (3.0 ABVE)
3:30 - 4:30 pm
1.0 CEUs (1.5 ABVE)
Assessing Medical Aspects of Rehabilitation with the
Earning Capacity Assessment Form-2 (ECAF-2)
4:30 - 5:30 pm
1.0 CEUs (1.5 ABVE)
Killer Cures: The Untoward Effects of Treatment and
Disability
3:30 - 4:30 pm
1.0 CEUs (1.5 ABVE)
Assessing Medical Aspects of Rehabilitation with the
Earning Capacity Assessment Form-2 (ECAF-2)
4:30 - 5:30 pm
1.0 CEUs (1.5 ABVE)
Killer Cures: The Untoward Effects of Treatment and
Disability
Saturday, March 26, 2011
Saturday, March 26, 2011
8:00-9:15 am
1.25 CEUs (1.875 ABVE)
Forensic Testimony for Psychiatric Conditions Using Social
Security Format; RFC, GAF, Malingering,
Consulting/Treatment Dichotomy
9:15-10:30 am
1.25 CEUs (1.875 ABVE)
8:00-9:15 am
1.25 CEUs (1.875 ABVE)
Forensic Testimony for Psychiatric Conditions Using Social
Security Format; RFC, GAF, Malingering,
Consulting/Treatment Dichotomy
9:15-10:30 am
1.25 CEUs (1.875 ABVE)
10:45 am-12:00 pm
1.25 CEUs (1.875 ABVE)
10:45 am-12:00 pm
1.25 CEUs (1.875 ABVE)
1:15-2:15 pm (Track 1)
1.0 CEUs (1.5 ABVE)
Report Writing Peer Review Workshop (Part One)
1:15-2:15 pm (Track 1)
1.0 CEUs (1.5 ABVE)
Report Writing Peer Review Workshop (Part One)
1:15-2:15 pm (Track 2)
1.0 CEUs (1.5 ABVE)
2:30-3:30 pm (Track 1)
1.0 CEUs (1.5 ABVE)
1:15-2:15 pm (Track 2)
1.0 CEUs (1.5 ABVE)
2:30-3:30 pm (Track 1)
1.0 CEUs (1.5 ABVE)
2:30-3:30 pm (Track 2)
1.0 CEUs (1.5 ABVE)
Employer Validation of Acceptable Absenteeism Rates in
Forensic and Social Security Venues
3:45-5:30 pm (Track 1)
1.75 CEUs (2.625 ABVE)
2:30-3:30 pm (Track 2)
1.0 CEUs (1.5 ABVE)
Employer Validation of Acceptable Absenteeism Rates in
Forensic and Social Security Venues
3:45-5:30 pm (Track 1)
1.75 CEUs (2.625 ABVE)
3:45-5:30 pm (Track 2)
1.75 CEUs (2.625 ABVE)
Testimony in Depositions and Trials: For the Expert with
Little Testifying Experience or Veterans Who Want to Learn
3:45-5:30 pm (Track 2) ETHICS 1.75 CEUs (2.625 ABVE)
Testimony in Depositions and Trials: For the Expert with
Little Testifying Experience or Veterans Who Want to Learn
Sunday, March 27, 2011
Sunday, March 27, 2011
8:30-10:00 am
1.5 CEUs (2.25 ABVE)
The Economic Recession and Vocational Assessments:
How Current Economic Times are Forcing Us to Rethink
Our Business
10:15-11:15 am
1.0 CEUs (1.5 ABVE)
8:30-10:00 am
1.5 CEUs (2.25 ABVE)
The Economic Recession and Vocational Assessments:
How Current Economic Times are Forcing Us to Rethink
Our Business
10:15-11:15 am
ETHICS 1.0 CEUs (1.5 ABVE)
11:15 am-12:15 pm
1.0 CEUs (1.5 ABVE)
11:15 am-12:15 pm
ETHICS 1.0 CEUs (1.5 ABVE)
Total CEUs possible for ABVE is 27.0 (including pre-conference session).
Total CEUs possible for all other bodies is 18.0 (including pre-conference).
NBCC
APA
Verification
12
2011 Conference
Evaluation Form
Please complete this overall conference evaluation form to give the planning committee your feedback on the
conference as a whole.
Logistics Rating
Poor
1.
What was most helpful in getting you to attend this conference:
a) Printed Materials
1
2
3
4
b) Email Broadcasts
1
2
3
4
b) Orlando, FL location
1
2
3
4
c) Seminar Content
1
2
3
4
d) Needed CEU’s
1
2
3
4
Satisfactory
Outstanding
5
5
5
5
5
6
6
6
6
6
7
7
7
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10
2.
Helpfulness of Registrar and Assistants
1
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3.
Parking Availability
1
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4.
Seating Comfort
1
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5.
Quality of Sound System
1
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Room Lighting
1
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Room Temperature
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Quality & Adequacy of Sleeping Rooms
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NA
Other comments you would like to leave the committee: (Thanks!)
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
YOUR NAME (optional)______________________________________________________________________
13
14
ABVE 2011
Annual Conference
Conference Session
Handouts
16
www.ottobockus.com
Alabama State University
Program Coordinator
Rehabilitation Services
j.chadduncan@gmail.com
J. Chad Duncan
www.abcop.org/resources/StateswithOandPLicensure/Pages/Default.
aspx
States with Licensure:
www.oandp.com/facilities/
To find a facility in your area:
www.abcop.org/Pages/Directory.aspx?searchtype=Individual
To find a credentialed individuals and Facilities in your area:
This handout is to be used as a
resource guide for upper
extremity prosthetics. Included
are references for ABC certified
Prosthetists and Orthotists, as
well as organizations that work
with upper extremity prosthetics.
This information does not
provide an exhaustive list of all
resources nor does it endorse
any one company.
ABVE 2010 - Orlando
17
www.touchbionics.com/
i-Limb Pulse produced by
Touch Bionics
J. Chad Duncan, Phd, CRC. CPO
Upper Extremity PX
J. Chad Duncan, PhD, CRC, CPO
Prosthetic Resource Guide
Various Upper Extremity Companies
Link: www.utaharm.com/index.php
Motion Control
www.oandp.org/
Resources: www.abcop.org/resources/Pages/Links.aspx
• American Academy of Orthotists
and Prosthetists (AAOP)
• Utah Arm
www.utaharm.com/index.php
• ProControl 2
www.utaharm.compc2.php
www.aabcp.org/
www.aopanet.org/
www.amputee-coalition.org/
• MC Hand / EDT
www.utaharm.com/etd.php
Otto Bock
• Michelangelo Hand: you tube video:
www.youtube.com/watch?v=pOgfuDrtZyc
Link: www.ottobockus.com
www.ispoint.org/
www.dsusa.org/aboutoverview.html
www.essentiallywomen.com/
• International Society for
Prosthetics and Orthotics (ISPO)
• System Electric Hand
www.oandpcare.org/
www.pedorthics.org/
J. Chad Duncan, PhD, CRC, CPO
• iLimb Pulse
www.touchbionics.comPulse
• iLimb Hand
www.touchbionics.com/i-LIMB
• www.touchbionics.com/ProDigits
• ProDigits:
Link: www.touchbionics.com/
Touch Bionics
www.ottobockus.com/cps/rde/xchg/ob_us_en
hs.xsl/6901.html
www.naaop.org/
• Essentially Women® Group
Purchasing Organization
• Disabled Sports USA
• American Orthotic & Prosthetic
Association (AOPA)
• Amputee Coalition of America
(ACA)
• American Association of Breast
Care Professionals (AABCP)
18
• National Association for the
Advancement of Orthotics and
Prosthetics (NAAOP)
• O & P Care.org
www.opcareers.org/
• National Commission on Orthotic www.ncope.org/
& Prosthetic Education (NCOPE)
• O & P Careers.org
• Pedorthic Footwear Association
www.pedorthicfoundation.org/
• Orthotic and Prosthetic Assistance www.opfund.org/
Fund (OPAF)
• Pedorthic Foundation
Note: This is not an exhaustive list nor endorses any one company.
Upper Extremity PX
19
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32
Killer Cures
The Untoward Effects of Treatment and Disability
Presentation by Linda A. Stein, MBA. Ed.M., CRC, CCM
1
Personal Disclaimer
This presentation is being made to heighten
awareness of the complexity and multiple
options a clinician needs to consider in
treating a person with a disabling
condition. Although medications and
treatment options are cited, it is in no way
an endorsement or a disapproval of any
specific treatment. The pervasive theme is
sustainable, optimal functioning with the
least harmful untoward effects.
2
33
Stein
Obsolete Remedies:
what was once thought
•
Butter for burns
•
Cocaine - By the 1880s in the United States it was freely prescribed by
physicians for such maladies as exhaustion, depression, and
morphine addiction and was available in many patent medicines
•
Cupping - Glass or bamboo cups are placed on the skin with suction,
which is believed to influence the flow of energy
•
Leeches - alternative treatment to blood-letting, the FDA on 6/28/04
approved the commercial marketing of leeches for medical purposes
•
Blood-Letting - antiquated and abandoned practice of draining blood
to cure diseases
•
Thalidomide – prescribed for morning sickness, responsible for birth
defects in U.S. and Europe
•
Tourniquet - no longer a standard practice; direct pressure is now
advocated
3
Psychosocial Disorders
• Bipolar (Lithium; Depakote; Trileptal)
• Depression (Pristiq; Prozac; Abilify; ECT)
• Anxiety (Xanex; Sedatives)
• Obsessive-Compulsion Disorders (Luvox, Zoloft,
Anafranil, SSRIs) vs.Cognitive Behavioral Therapy "exposure response-prevention" (ERP) – “ERP is the
only therapy endorsed by the OC Foundation”
• Attention Deficit (Hyperactivity) Disorders
(Adderall, Ritalin, Strattera, Wellbutrin, Vyvanse)
4
34
Stein
Diagnoses: Getting it Right!
• Major Depression vs. Bipolar Disorder
• Antidepressants are contraindicated for an initial
presentation of depression, if that presentation is
the initiation of bipolar disorder. To treat with
antidepressants alone, if bipolar exists, will
increase likelihood of precipitation of a
mixed/manic episode
• Determination often rests with careful psychiatric
screening
i ffor ffamily
il hi
history
t
off suicide,
i id bi
bipolar
l
disorder and depression. May have been
referred to by outdated descriptions such as
“Involutional Melancholia” or “Manic Depression”
5
Lithium Risks
• Remains one of the most widely used
medications for treatment of bipolar
disorders in spite of long known problems
related to kidneys, thyroid and weight
• Decreasing kidney function affects
minimally 1 out of 10, but more likely 1 of 2
who have taken lithium over extended
periods of time, e.g. over ten years
• Significant number of dialysis recipients
6
35
Stein
Physical/Cognitive Consequences
•
•
•
•
•
Kidney dysfunction
Liver dysfunction
Diabetes
Tardive Dyskinesia, e.g. lip smacking
Brain Dysfunction (motor skills; memory;
cognitive slowing)
• Suicide
7
Case Study
•
At age15, client was diagnosed with Manic-Depressive Disorder following
experimental use of recreational drugs including Ecstacy. There was a genetic
history from maternal grandmother. Placed on Lithium (1980). Side effects of
psoriasis and weight gain occurred
•
Completed AAS degree with increased manic symptoms. Placed on Depakote.
Stabilized approximately 10 years when psychotic break occurred following
non-compliance with medication. Could no longer tolerate stress of work and
went on SSDB
•
At age 44, kidney failure occurred attributed to previous history of Lithium
usage. Psychotic break due to weaning off of Depakote when pancreatitis
occurred which was thought to be brought on by Depakote
•
Stabilized mood initially with Seroquel; then with Trileptal (anticonvulsant) and
dependent on dialysis. Awaiting kidney transplant
•
Team consists of: internist, psychiatrist, nephrologists and dialysis staff,
dermatologist, gynecologist, significant other and supportive family members.
Psychiatrist and internist serve as the case managers for treatment
coordination
8
36
Stein
Antidepressants
• More than 27 million Americans take
antidepressants,
p
, making
g them the most
commonly prescribed medication in this nation
• SSRI (Selective Serotonin Reuptake Inhibitors)
includes Prozac, Celexa, Lexapro, Paxil. Works
by lifting the levels of serotonin, a
neurotransmitter, that increases a sense of well
being
• SNRI (S
(Serotonin–Norepinephrine
t i N
i
hi R
Reuptake
t k
Inhibitor) includes Effexor and Cymbalta. Works
by increasing both neurotransmitters of
serotonin and norepinephrine
9
Antidepressant Side Effects
• Suicidal ideation and behavior in children,
adolescents and young adults (under age 25) in
short term studies of Major Depressive Disorder
and other psychiatric disorders
• Nervous System Disorders: dizziness, tremor,
headache, somnolence, attention deficit
• Psychiatric disorders: insomnia, anxiety,
i it bilit abnormal
irritability,
b
ld
dreams
• Renal, urinary, respiratory, cardiological, skin,
and sensory symptoms
10
37
Stein
“Antidepressant Discontinuation
Syndrome”
• Can occur when medications are reduced
following
g 5-6 weeks of ongoing
g g use,, which is the
typical time frame for effectiveness to be
optimally obtained
• A range of mental and physical effects which
include fatigue, anxiety, agitation, insomnia,
visual disturbances, and what is known as “brain
zaps” are described as a strange sensation
similar to an electrical shock to the head and
body
• About 20% of patients will experience some type
of symptoms of discontinuation
11
Correlation vs. Causation
• In spite of placebo studies, and consideration of
statistical significance
significance, one needs to consider if
the existence of symptoms occur simultaneously
or as a specific consequence of a specific
medication.
• Benefit versus risk factors should always be
considered; careful ongoing monitoring is key to
determining that the short term benefit
outweighs the longer-term risks, for promotion of
sustainable remission and rehabilitation
12
38
Stein
Electroconvulsive Therapy
Electroconvulsive therapy (ECT) is a procedure in which a brief
application of electric stimulus is used to produce a generalized
seizure It is not known how or why ECT works or what the
seizure.
electrically stimulated seizure does to the brain. In the U.S. during
the 1940’s and 50’s, the treatment was administered mostly to
people with severe mental illnesses. During the last few decades,
researchers have been attempting to identify the effectiveness of
ECT, to learn how and why it works, to understand its risks and
adverse side effects, and to determine the best treatment
technique. Today, ECT is administered to an estimated 100,000
people a year, primarily in general hospital psychiatric units and in
psychiatric hospitals. It is generally used in treating patients with
severe depression, acute mania, and certain schizophrenic
syndromes. ECT is also used with some suicidal patients, who
cannot wait for antidepressant medication to take effect.
13
ECT Controversy
•
After 60 years of use, ECT is still the most controversial psychiatric
treatment. Much of the controversy surrounding ECT revolves around its
effectiveness vs
vs. the side effects
effects, the objectivity of ECT experts
experts, and the recent
increase in ECT as a quick and easy solution, instead of long-term
psychotherapy or hospitalization.
•
Because of the concern about permanent memory loss and confusion related
to ECT treatment, some researchers recommend that the treatment only be
used as a last resort. It is also unclear whether or not ECT is effective. In
some cases, the numbers are extremely favorable, citing 80 percent
improvement in severely depressed patients, after ECT. However, other
studies indicate that the relapse is high, even for patients who take medication
after ECT. Some researchers insist that no study proves that ECT is effective
for more than four weeks.
•
During the last decade, the “typical” ECT patient has changed from low-income
males under 40, to middle-income women over 65. This coincides with
changing demographics. The increase in the elderly population and Medicare,
and the push by insurance companies to provide fast, “medical” treatment
rather than talk therapy. Unfortunately, concerns have been raised concerning
inappropriate and even dangerous treatment of elderly patients with heart
conditions, and the administration of ECT without proper patient consent.
14
39
Stein
Pain Management
•
Back – Most common kind of recurring pain
•
Lower back pain is a condition that 8 out of 10 Americans will
experience at some point and is estimated to cost $25 billion annually
(Duke University); 5th most common reason for all physician visits in
the U.S.
•
Workers’ Compensation and time lost from work costs an estimated
additional $25 billion per year
•
One half of all working Americans admit to having back pain
symptoms each year
•
Acute vs. chronic is dependent on duration, with chronic being longer
than 3 months and getting progressively worst
•
Treated by orthopedic surgeon, chiropractor, massage therapist,
physical therapist, acupuncturist, acupressurist
15
Pain Medications and Addiction
• Over the counter drugs (Sudafed; Cough
Medications)
• Prescribed drugs of: Flexeril, Vicodin,
Hydrocodone, Hydrocontin, Oxycontin,
Oxycodone, Oxymorphone, Hydrocodein
• Alcohol
• Synergistic Effect
16
40
Stein
Opioids
Addiction to opioid prescription
painkillers also called “opioid
painkillers—also
opioid
dependence”—has become increasingly
common. Although prescription painkillers
such as OxyContin® and Vicodin® are an
important resource for treating chronic
pain they can also be highly addictive
pain,
addictive.
What begins as pain therapy can lead to
uncontrolled use of painkillers or a
substance abuse problem
17
Street Corner Society
Below are some common street names for prescription opioid painkillers. All of
these drugs can be habit-forming or addictive, and lead to a substance abuse
problem.
Brand Name
Generic
Common Street Name
•
Vicodin®
Hydrocodone
Vike, Vic, Watson-387
•
OxyContin®,
Percodan®,
Percocet®
Oxycodone
Oxy, OC, Percs, Cets
•
Durgesic®,
Actiq®
and
Fentanyl
•
Darvon®
Propoxyphene
•
Demerol®
Meperidine
Demmies, synthetic heroin
•
MS Contin®,
Avinza®
Morphine
Morph, Miss Emma, M
Tylenol® 3
Codeine
•
Apache, China Girl, TNT, China white, Murder 8, Tango
Cash, Dance fever, Jackpot, Goodfella, China Town
Pinks,
Pinks Footballs,,
Footballs Yellow 65s,
65s Ns,
Ns PPX
Cody, Captain Cody, Schoolboy
18
41
Stein
Case Study
“The examinee is with medical certainty
di bl d ffrom th
disabled
the very medication
di ti th
thatt h
has
been provided to help him. He reports that
he is unable to think or function while on
the medication despite having subjective
pain reductions of 40-60%.” “It is possible
that the opioid itself is inducing a
hyperalgesia that is perpetuating the pain
syndrome.”
19
Habituation vs. Addiction
Habituation
1. the gradual adaptation to a stimulus or to the environment, with a
decreasing response.
2. an older term denoting sometimes tolerance and sometimes a
psychological dependence due to repeated consumption of a drug,
with a desire to continue its use, but with little or no tendency to
increase the dose.
Addiction is a persistent, compulsive dependence on a behavior or
substance. The term has been partially replaced by the word
dependence for substance abuse. Addiction has been extended,
however, to include mood-altering behaviors or activities. Some
researchers speak of two types of addictions: substance addictions
and process addictions (for example, gambling, spending, shopping,
eating, and sexual activity). There is a growing recognition that many
addicts, such as polydrug abusers, are addicted to more than one
substance or process.
20
42
Stein
Addiction
•
•
•
•
•
In addition to a preoccupation with using
and acquiring the abused substance
substance, the
diagnosis of addiction is based on five
criteria:
loss of willpower
harmful consequences
unmanageable lifestyle
tolerance or escalation of use
withdrawal symptoms upon quitting
21
Case Study
Having worked with substance abusers, in
th capacity
the
it off vocational
ti
l rehabilitation
h bilit ti
counselor, it became apparent that drug
dealers were addicted to the lifestyle they
were able to live due to the inflated income
and excitement it provided. That was a
greater barrier to legitimate employment
than the addiction to the substances which
were in remission or had not existed
22
43
Stein
Medication Errors
• Most common dispensing errors, based on
research conducted from 1966
1966-2008,
2008 as
identified by community and hospital pharmacies
were: dispensing the wrong drug, strength, form
or quantity, or labeling medication with the
wrong directions.
look alike and
• Factors influencing errors were look-alike
sound-alike drugs, low staffing, computer
software, high work load, interruptions,
distractions, and inadequate lighting.
23
Survey of Hospital Systems
• The Institute for Safe Medication Practices
and the University of Illinois at Chicago
Chicago,
College of Pharmacy, undertook a hospital
survey
• Through analysis, it was shown that over
one third of all medication errors involved
the following six categories: allergies
allergies,
insulin, heparin, opiates, PCA devices and
potassium concentrates
24
44
Stein
Statistical Reporting
• The Institute of Medicine (1999) showed
th t 100
that
100,000
000 deaths
d th per year in
i the
th U.S.
US
were attributed to “health care harm”
• Centers for Disease Control (2007)
reported that an additional 99,000 people
die annually from “hospital-acquired
hospital acquired
infections”
25
Case Study
• Dennis Quaid and his wife had a parental
nightmare
g
during
g 2007,, when their 12 day
y old
twins. who were treated for staph infections,
were accidentally administered twice with
heparin for adults, which was a dosage 1,000
times greater than which was to be prescribed
• Although the babies were saved with protamine,
the event triggered research and activism to
counter these types of medical errors
• Joined forces with Dr. Denham, a leader in the
Patient Safety Movement, at Texas Medical
Institute of Technology (TMIT)
26
45
Stein
“Chasing Zero”
Revolutionizing Safe Practices
•
TMIT is driving production of multimedia development of stories to improve
patient safety in hospitals. Certain broadcast programs will be shown globally,
and then will be made available to hospital leadership and front-line
performance teams.
teams Stories will include consumers
consumers, front
front-line
line caregivers,
caregivers
clinical and non-clinical leaders of hospitals, and international subject matter
experts. The series of "arc to action" stories will be told to inspire both
community and hospital leaders to act locally.
The goal is to save lives, save money, and deliver value to the community
through extraordinary impact by improving ordinary things.
To open the Hospital Leaders Toolbox, click here.
To receive the Chasing Zero DVD, or to contribute to our cause, please click
here.
To see the trailer and summary of our next documentary Out of the Danger
Zone, click here. Chasing Zero: Winning the War on Healthcare Harm trailer.
Click on the image above to play the documentary trailer.
Click here to view the entire 53-minute documentary.
•
View on www.safetyleaders.org/pages/chasingZeroDocumentary.jsp
27
Safe Practice Upgrades
• Shared nursing rounds for improved
communication and patient rapport
• Checklists for standardization and
comprehensive consistency
• Matching bar codes for patient profile with
patient medication; audible alarms for
incompatibility
• Simulation in the lab is key to moving forward
• Mayo and Cleveland Clinics as model facilities
28
46
Stein
Avoiding Medication Errors With
the “3 Rs”
Risks, Respect, Responsibility for safe medication
use:
• Recognize all medicines have risks as well as
benefits
• Respect the power and value of medicines when
properly used
• Remember
R
b th
thatt medicine
di i safety
f t iis also
l about
b t
personal responsibility; learn what you need to
know regarding safe and appropriate use
29
Boomers Beware!
• Arthritis and NSAIDS (non-steroidal anti-inflammatory
drugs)
g )
• Joint Replacements (hip; knee)
• Osteoporosis
• Artificial Disc Replacement vs. Spinal Fusion
• Cardiologic Issues, e.g. stents
• Diabetes e.g. Avandia linked to heart attacks, stroke yet
remains on the market
• Sensory and cognitive loss
• Sexual Dysfunction
• Generalized deconditioning
30
47
Stein
Popular Standards
• Nexium for gastroesophageal reflux disease. By
suppressing acid it allows entry of bacteria and
mold to enter intestinal tract, causing other
problems
• Ibuprofen and aspirin for muscle and joint pain.
Has been associated with being the leading
cause of GI bleeding in U.S.
• Lipitor
Li it ffor llowering
i cholesterol
h l t l numbers.
b
C
Can
interfere with hormone production which can
cause imbalance and can lower cholesterol too
much, contributing to mortality rates.
31
Alternative Options
• Healthful diet with high antioxidants and
omega 3 fatty acids
• Vitamins and supplements
• Exercise and physical therapy
• Massage Therapy
• Meditation
• Hypnosis
• “Fresh Air Therapy” e.g. surfing in England
32
48
Stein
Top 12 Vitamins & Supplements
B6
B12
C
D
E
K
Calcium
Magnesium
Omega 3 Fatty Acids
Folic Acid
Potassium
Selenium
33
Power of Positive Thinking
• Baby boomers have been an incredible
generation and will continue to be
• People need to be empowered to make
optimal choices toward their optimal health
• Stay informed and educated. There are
new improved methods of treatment being
di
discovered
d allll th
the titime
• Keep your heads up and follow your path
of belief and “bliss”
34
49
Stein
Resources
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
ADHDCentral.com
Aarp.org/health
Healthcentral com
Healthcentral.com
Healthline.com
HealthSquare.com
Medical-dictionary.the freedictionary.com
Ncbi.nlm.nih.gov/pubmed
mha.org
Nytimes.com/science
Psycheducation.org/depression/meds/LithiumRisks.htm
Personal Case Studies
Safetyleaders.org
Turntohelp.com
Rehabpub.com
Westchestermagazine.com (February, 2011)
35
50
Stein
51
Cohen
52
Cohen
53
Cohen
54
Cohen
55
Cohen
56
Cohen
57
Cohen
58
Cohen
59
Cohen
60
Cohen
61
Cohen
62
Cohen
63
Cohen
64
Cohen
65
Cohen
66
Cohen
67
Cohen
68
Cohen
69
Cohen
70
David San Filippo, Ph.D.
I.
Introduction
II.
Case Studies
III.
Types of Vertigo
a) Spontaneous vertigo
b) Recurrent attacks of vertigo
c) Positional Vertigo
IV.
Impact of Vertigo on Occupational Abilities and Worker Trait Factors
Occupational Abilities
Cognitive abilities
Perceptual Speed
Selective Attention
Spatial Orientation
Speed of Closure
Physical abilities
Dynamic Flexibility
Extent Flexibility
Gross Body Equilibrium
Psychomotor
Reaction Time
Response Orientation
Sensory
Depth Perception
Glare Sensitivity
Worker Trait Factors
Physical Demands:
71
San Filippo
Balancing
Stooping
Crouching
Reaching
Depth Perception
Field of Vision
Temperaments:
Performing Varied Duties
Dealing with Stress
Environmental Factors:
Vibrations
Proximity to Moving Machinery
Exposure to Electrical Shock
Exposure to High Places
Exposure to Radiation
Working with Explosives
Exposure to Toxic & Caustic Agents
Exposure to Noise
V.
Vocational Impact Due to Equilibrium Impairments
VI.
Determination of Disability due to Equilibrium Impairments
Class 1 - Impairment of the Whole Person, 0%:
Class 2 - Impairment of the Whole Person, 5-10%:
VII.
Conclusion
72
San Filippo
OIDAP
Occupational Information
Development Advisory Panel, Social
Security Administration
What is OIDAP?
On December 09, 2008, Commissioner of Social Security, Michael J.
Astrue established the Occupational Information Advisory Panel
(OIDAP) under the Federal Advisory Committee Act. (FACA)
OIDAP was to provide advice and recommendations related to SSA’s
disability program in the following areas:
*medical and vocational analysis of disability claims,
*occupational analysis, including definitions, rating and capture of
physical and mental/cognitive demands of work,
*data collection: use of occupational information in SSA disability
programs, and
*any other area(s) that would enable SSA to develop an OIS suited
to its disability programs and improve the medical-vocational
adjudication policies and processes.
73
Martindale

On January 7,2011, Commissioner of Social
Security , Michael J. Astrue renewed the
Charter for OIDAP.

OIDAP provides independent advice and
recommendations on plans and activities to
create an occupational information system
(OIS)

3 Federal Advisory Committee Act (FACA)
guidelines under which SSA chartered OIDAP
and to which they are committed:

Their purpose is advisory only
Their role is independent of the chartering agency
Their responsibility to the public is transparency and
openness.
Their work with SSA is providing advice and
recommendations.

Mission
“to provide independent advice and
recommendations on plans and activities to
replace
p
the Dictionary
y of Occupational
p
Titles…
and… advise the agency on creating an
occupational information system (OIS) tailored
specifically for SSA’s disability programs and
adjudication needs.”
74
Martindale

OIS must reflect work requirements – SSA must be able to
compare human functional deficits resulting from a sever
physical or mental impairment with the physical and mental
requirements of work.

OIS must reflect the national existence and incidence of
work
k – Any
A occupational
ti
l resource mustt reflect
fl t work
k that
th t
actually exists in “significant numbers” in the US (either
throughout the nation or in several regions)

OIS must meet the burden of proof in a legally defensible
way – SSA has a burden of proof regarding its
determination that a claimant can work despite a medical
impairment. SSA must show what types of jobs a claimant
can perform.

The OIS is tailored specifically for SSA’s disability
programs and adjudication needs.

SSA requires advice and recommendations on the
use of occupational information in SSA’s
SSA s disability
programs.

The research design of the OIS, including the
development and testing of an OIS content model,
and taxonomy, work analysis instrumentation,
sampling, and data collection and analysis, is
underway.

The new OIS will assist the SSA to meet its
burden of proof, it must be forensic defensible,
it will reflect all work nationally and link
residual functional capacity to the
requirements off work.
k

The data collection instrument was pilot tested
in January, 2011.
75
Martindale
What’s wrong with the Dictionary of
Occupational Titles?
Why isn’t the Standard Occupation Classification
manual g
good enough?
g
Do we need a new Occupational Information
System?
Do you as a Vocational Professional think the
system needs to be updated?

DLU – date last updated DLU: 77 or 89 or 91

Definitions – outdated and antiquated. We all have our
favorite ones. (what are yours)

What
Wh are the
h core work
k activities
i i i off each
h job?
j b?

Trailer – brief – GOE, Strength, GED, SVP, DLU

Challengeable by attorneys in a hearing or a court
proceeding.

What else do you see wrong with the DOT?

DLU – date last updated, Occupational data is
based on the 1990 Census and the DOT revised
4th edition. (21 years old)
Physical
y
demands – what are the minimum /
maximum level of requirements needed to
perform the work?
Interpretation of physical demands and
working conditions proposed in a hypothetical
question. (can you decipher, quickly)

76
Martindale
The creation of a new Occupational Information
System is needed to replace the Dictionary of
Occupational Titles for Social Security
Administration’s (SSA’s) disability
adjudication system.

Occupations aggregated at a level to support individualized disability
assessment
A cross-walk to the Standard Occupational Classification
Precise occupationally-specific data
Core work activities
Minimum levels of requirements needed to perform work
Observable and deconstructed measures
A manageable number of data elements
Sampling methodology capturing the full range of work
inter-rated agreement justifying data inference
Data collection of high quality data
Valid, accurate, and reproducible data
Whether core work activities could be performed in alternative ways
Terminology that is consistent with medical practice and human function.
A new unit within the Social Security
Administration, announced on Nov. 17, 2010.
Charged with conducting the research and
development of the new OIS.
Consists of two branches: one dedicated to
research,
h design,
d i
development,
d
l
t scientific
i tifi
standards, testing, as well as data collection.
The second branch is dedicated to program
integration to insure the OIS is developed to meet,
SSA’s legal, program and operational needs.
77
Martindale

Contractor awarded to assist in developing the
job analysis format that will be used, as well as
recruiting, training, and certifying analysts.

What can you do?

Stay involved, check the Federal Register for information
Give public comment
Visit the website – www.socialsecurity.gov/oidap
Keep updated on new information
Attend quarterly meetings
Get on the electronic e-mail list
Be on board when the new system changes
Watch for educational opportunities on the OIS
Know what’s new and how to use it in your professional career
SSA’s OIS will be tailored for use in its
disability programs.
SSA only considers jobs a claimant can perform
now despite
p impairments
p
SSA does not consider jobs a claimant can
potentially perform with training or
accommodations as vocational rehab
professionals do.
78
Martindale

OIDAP seeks your involvement so they can deliver
the best possible advice and recommendations to
SSA as it develops the OIS created specific to the
needs of human function.
Keep
p informed on the development
p
of the OIS and
the activities of the OIDAP, by attending the
quarterly meetings in person or by teleconference.
Send a request to place you on the electronic email list to www.oidap@ssa.gov.
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Graham
83
Graham
84
Graham
85
Graham
86
Graham
87
Graham
88
Graham
89
Graham
90
Graham
91
Graham
92
Graham
93
Graham
94
Graham
95
Graham
96
Graham
97
Graham
98
Use of VE Testimony in Social Security Disability HearingsVEs Are Not Just Reciters of the DOT!
Presenter: Samuel Edelmann
The use of VE’s in Social Security Hearings: Evolving trends and issues
1.What do judges want from a VE? How does it differ from what attorneys want?
Tailoring testimony for specific judges, based on history or other expectations
Providing the answer to the question asked, nothing more.
Asking for clarification of past work.
ALJ and attorney expectations that VEs should be familiar with the regulatory definitions
of sedentary, light and medium work.
Handling follow-up questions from the judge.
The cultural differences of different ODAR offices. Do "wrong" answers keep VE's from
getting work?
2. What do Ve's want from the judge?
Well-defined hypotheticals stating actual functional limitations.
Medical records?
How should VE's and judges handle over-zealous cross examination of VE by reps?
Should VE object and request ALJ opinion whether to respond?
3. Is VE testimony in ODAR hearings art or science?
The transferability of skills, the citation of jobs, the discrepancy between the definitions
in the DOT and current job market, the lack of definitive job numbers.
all point to this being an art based on field experience.
Will OIDAP speak to these issues to satisfy judges and attorneys?
As time allows:
How do VE's deal with probationary periods vis-a-vis production rates, absenteeism?
Is production rate and absenteeism tolerance affected not only by a probationary period
but also are tolerances different entry level jobs even beyond the probationary period?
Is an entrenched worker one who completes the probationary period or does it take
longer?
How is the sit-stand option spoken to in realistic terms in hearings?
Do full-time unskilled jobs still exist in significant numbers?
99
Edelmann
100
INTERNATIONAL LIFE CARE PLANNING:
TECHNIQUES, STRATEGIES AND DATABASES
KEITH SOFKA, ATP (RETIRED)
PENELOPE CARAGONNE, PH.D., CLCP
CARAGONNE AND ASSOCIATES, LLC
AJIJIC, JALISCO, MX
DEVELOPED FOR
THE AMERICAN BOARD OF VOCATIONAL EXPERTS (ABVE)
ANNUAL FORENSIC CONFERENCE
MEDICAL ASPECTS OF DISABILITY
MARCH 25 - 27, 2011
ORLANDO, FLORIDA
101
Carragonne & Sofka
1.
A Basic Template for Conducting Research in Another Country
a.
Basic referral receipt.
b.
Get copy of plan if you’re on the defense, and/or all medical records.
c.
What is your role in the case? Are you a testifying expert, a non-testifying
consultant to the LCPlanner, or a non-testifying expert consultant to the
attorney at trial?
d.
Will you be working directly with the attorney or through a life care
planner? Your retention contract should be with the attorney, your primary
communications should be with the attorney, unless you absolutely trust
the life care planner and can do a contract with them. Distinguish between
small and large scopes of work.
e.
Will they need a testifying expert from another country? In health system?
In service delivery? In economics? In medicine?
f.
Can you speak or negotiate in the language? If yes, go for it. If no, get a
guide.
g.
Stay in every other day contact with your client and/or get him or her to
designate a person in his/her office to be your point person for information
and approval.
h.
To find a guide, make contacts with major hospitals to locate bi-lingual
physicians (Google search with Babelfish so you can translate the pages
you find). Find a physician or hospital director who is conversant with and
can use email.
i.
Make contacts with the Consulate and if they won’t help, ask for a list of
physicians or ask for a list of translators.
j.
Tell your client you may need to ire a consultant and/or translator and that
you will pay their bill and pass it on to them.
k.
Hire either a translator or negotiate with a physician for assistance.
l.
Offer to pay your consultants per hour once you have determined how
much you should pay for a physician/consultant (beware of the gringo tax).
m.
Develop a short written description of the person, or, a medical resume of
their injury and needs in the language of the country to send to your
consultant.
n.
Translate the list of items in the Care Plan to the language of the country.
o.
Once you have negotiated for a product, send the consultant your list of
everything that needs to be priced.
p.
Make an arrangement that you will pay for only the complete delivered list
of prices by a date certain.
q.
Make sure you have lengthy deadlines as other cultures do not work on
US time frames. If, for example, you get a pricing request with a 2 day
turn-around (as we just did), decline it.
r.
Do a site visit with a physician or nurse if you can (it’s always better).
s.
Explain to your client that if you are a testifying expert, you will have much
more credibility if you have visited the setting and can speak from direct
contact.
t.
Ask your consultant to take you to all the resources so you can see them
for yourself.
u.
Photograph every place you go.
102
Carragonne & Sofka
v.
w.
x.
y.
z.
aa.
bb.
When you’re with vendors, get their emails, ask for written quotes, and
determine if the item can be shipped in and is available.
If not available, what would the Customs duty be to ship any item in (25%
up charge?).
Are there repair resources for the item to be shipped, and if not, consider
buying two of the item, so they can send one to a major metropolitan area
for repair and still have one working item.
Remember that the availability of online information is unique to the US
and western Europe.
Collect all of your data in a comparable format and enter it incrementally.
Scan and save your data files in PDF so you backup each page of your
Cost Charts with your foundational information (See Mexico City plan for a
guide).
Take this entire file to your deposition so if questions are raised, you can
refer the opposing attorney directly to your file.
2.
A Basic Template for Presenting Your Findings (US and "X" Country Cost
Comparisons in One Chart) (3 Life Care Plans)
3.
Working with Economists and How to Present Your Cost Information to
Them
a.
Be sure to alert the Economist regarding the most current dates of your
data. Do not assume that they will read or even look at anything but your
summary sheet.
b.
Interview the economist on what he is expected to do and when
c.
Tell the economist that you give comparative converted figures (US Cost
compared to “x” country costs, and the conversion rate)
d.
Ask them if they need CPI figures.
e.
Ask them if they need inflation rates.
f.
Ask them if they will need wage data.
g.
Ask the attorney if you can communicate directly with the economist, and
if they want you to do it all by telephone, so he continues to appear to be
an expert economist.
h.
Confirm by email or by telephone with the attorney what you will be doing
additional to the LCP research.
i.
When you finish your cost research, send one file to the attorney and one
to the economist.
j.
Obtain the economist’s final version of your numbers, so you can confirm
they understood the translation you sent.
4.
Attorney Perspectives on "Primitive" Local Medical Services (How to
Validate or Invalidate This Perspective)
a.
Find out fixed your attorney’s ideas are about the culture and his/her level
of cultural awareness
b.
If his level of awareness is low, tell him you will provide him with a lot of
pictures of the region, the home, and various vendors you will recommend
for his use during depositions
c.
Learn if they have a consultant/expert in immigration law
103
Carragonne & Sofka
d.
e.
f.
g.
If, as in one case, the opposing attorney is asserting primitive conditions
for services, ask what proof the opposing attorney is offering so you can
review it (Typically, plaintiff attorneys opine that the person will never go
back to “x” country, as the services are far superior in the US).
If the person resides in a fairly sophisticated town or city, offer to do a site
visit so you can counter this argument with photos of your own and help
him/her get photographic familiarity with the region and its services
If, however, the place where the person is primitive (as many are)
document where the resources are and provide funds in your plan to travel
to these resources, or, put a physician led-team together to do on-site
services in the home and train the nursing staff
Example from North Carolina case where the case manager only provided
resources for three months per year of supplies and no physician followup
5.
Cultural Considerations
a.
The kind of directness that we are accustomed to in the United States may
be viewed as aggressive or even rude in other cultures. Instead of
suggesting an idea, which will almost always be met with assent, it is
usually more productive to ask what this person would do in a similar
situation. For more information about this topic, see the book: Crouch, N.
(2004). Mexicans and Americans: Cracking the Cultural Code. London:
Nicholas Brealey Publishing.
6.
Surgeon Availability for Inpatient and Surgical Pricing
a.
Get a surgeon for pricing as soon as you can
b.
Do not rely on estimates of prices provided by non-surgeons.
c.
In some countries, Peru for example, it will not be possible to get surgical
pricing, unless you know a physician personally.
d.
There are no databases in foreign countries that are comparable to our
US databases.
e.
If possible, put your request for a procedure in writing.
7.
Why You Should Avoid Medical Tourism Sources
a.
While the availability of medical tourism in a particular country may be a
testament to the quality of the medical infrastructure, many procedures are
not offered by these companies. If your required procedure is not on the
list of typically offered procedures, you may never get a cost since you will
be setting off a chain of price investigating events so that a price for all
potential patients will be sought by the Medical Tourism Company. You
will find that the most common procedures are available such as knee and
hip replacements while a scar revision will require lengthy price
investigation. It would be better to find a physician who performs this
procedure through the methods outlined above. Also, the prices charged
by medical tourism operators often include all of the extras not required by
a resident such as housing, transportation, etc. Generally, the price will be
higher for the procedure although it will still be much less expensive than
the same procedure performed in the United States–see Gringo tax.
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Carragonne & Sofka
8.
Paginas Amarillas (Yellow Pages for a Given Country) and Seccion Amarilla
(How to Use the Internet)
a.
Sección Amarilla (http://www.seccionamarilla.com)
b.
Paginas Amarillo (http://www.paginasamarillas.com)
9.
Locating Specialist Physician and other Provider Databases
a.
Major Hospitals
b.
Labs and Clinics
c.
Durable Medical Vendors
d.
Farmacias
e.
Adaptive Transportation
f.
Consejo De Doctores by Discipline.
http://www.consejorehabilitacion.org.mx/
g.
Procuraduría Federal del Consumidor (Profeco includes National Cost
Database and the Department of Transparency)
(http://www.profeco.gob.mx/)
h.
IMSS (Department of Transparency)
http://www.imss.gob.mx/transparencia
i.
Defining the Procedure. The ICD-9 in Spanish.
http://www.worldlingo.com/ma/enwiki/es/ICD-9-CM_Volume_3
The ICD-9 is available in many languages from this same site.
10.
Life Expectancy Tables
a.
World Health Organization, Global Health Observatory. Life Expectancy
for 193 member nations.
http://www.who.int/healthinfo/statistics/mortality_life_tables/en/
11.
The Value of Site Visits (Resource Proximity, Resource Staffing, Services
Offered, etc).
Plaintiff Cases
a.
What you can learn from a site visit (Carmelo)
b.
Characteristics of the family’s needs for support
c.
Capability of the family to directly care for their family member
d.
Desire of the family for paid help
e.
Family needs for respite
f.
How patriarchal the family system is
g.
Family needs for architectural access or construction
h.
Family needs for help in managing resources
i.
Local resources for supplies, equipment, physician care, medications, and
nursing
j.
Desire for local resources to enter into contractual agreements with
insurance company
k.
Arrangements for getting bills from local vendors and physicians
l.
Arrangements for paying bills
Defense Cases
a.
Gain a better understanding of the resource network
b.
Sense of how wealthy or how poor the family is
c.
Proximity of resources to the family
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Carragonne & Sofka
d.
e.
Sophistication of resource network
Greater detail for setting up a resource network
12.
Health Insurance/Pension System (Original Constitutional Mandate , Recent
Amendments, Critiques of the System by Economists, Key Provisions, Types of
Worker Hospitals, Exclusions, What is Covered and Not Covered, Costs Per
Year in Mexico, Entering the System After a Catastrophic Injury, Translation
Resources for the Mexican IMSS document
a.
The Value of a Translated Health Insurance Document for Your Client
b.
Determining if the System will accept a catastrophically injured new
enrollee
c.
When injured workers can enter as an already enrolled family member’s
dependent
d.
Re-opening an old insurance account
e.
Two year rule
f.
Obtaining translated copies of the Mexican Health Care System.
MEXICANLAWS S.A. de C.V. <glenn@mexicanlaws.net>
13.
Commissioning a Report by In-Country Attorneys for Admission Into a US
Court
a.
Why you would do it
b.
Why you would not need to do it
14.
Giving a Deposition in Another Country (Use of Your Local Consulate as a
"Little Piece of America")
a.
Paying for use of their space
b.
Getting sworn in by a consulate representative
c.
Making arrangements for video or court-reporter services in advance
15.
Labor Market Databases (World-wide)
a.
The International Labour Organization
http://www.ilo.org/global/lang--en/index.htm
b.
Is in English, Spanish and French
c.
Contains data from most of the countries in the world (193 UN countries)
16.
Consumer Price Index Databases and How to Get (World-wide)
a.
Banco de Mexico. http://www.banxico.org.mx/index.html
b.
This information is kept by the central bank in each country. You can find
this by “googling” central bank, Bosnia, for example.
c.
Each central bank is required to keep this data
d.
Type in the term “Consumer Price Index” in the native language of that
country
e.
Less detailed information about each country’s CPI can be found at the
International Monetary Fund website. http://www.imf.org/ search for
statistical appendix and the name of the country.
17.
Setting Up Resource Networks with Insurance Companies or Other
Funding Sources (World-wide)
106
Carragonne & Sofka
a.
b.
c.
d.
e.
f.
g.
18.
Determine how they will pay bills
Send the names and all relevant information on each of the local vendors
to the insurance company
Get approval in writing that they agree to pay
Get a contact person to whom bills will be sent
Get their email address so the vendor can send bills to you
Get their bank wiring information so they can wire money
Send a bill and see if they pay it
Key Provisions of a Translated Document (Certified Translator, Original
Document, Payment Structure)
107
Carragonne & Sofka
108
109
Grimley, Sinsabaugh, Martin
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
Rights of the Vocational Expert
1. You may ask the judge if you have questioned about how you should answer the
question is posed.
2. You may refuse to answer questions that you do not understand and you may ask the
examining attorney to clarify the question
3. You may ask the judge with you can qualify your answer when the questions cannot
be answered with a "simple" yes or no.
4. You have the right to complete your answer and should protest if you are an
interrupted.
5. You may refer to written records to refresh your recollection or memory.
*Extracted from Blackwell et al. (2005, p. 50). There may be other rights guaranteed but the VE you should
check court procedure in the jurisdiction where they practice and consult their respective state code of
statutes.
Bibliography
Blackwell, T. (1991). The vocational expert primer. Athens, GA: Elliott & Fitzpatrick.
Blackwell, T. L., Field, T. F., Johnson, C. B. Kelsay, M. & Neulicht, A. T. (2005). The
vocational expert: Revised and updated. Athens, GA: Elliott & Fitzpatrick.
Deutsch, P. M. & Parker, E. C. (1985). Rehabilitation testimony: Maintaining a professional
Albany, NY: Matthew Bender
Field, T. F. & Sink, J. M. (1981). The vocational expert. Athens, GA: Elliott & Fitzpatrick.
Field, T. F., Weed, R. O. & Grimes, J. W. (1986). The vocational expert handbook. Tucson,
AZ: Valpar International.
127
128
The Economic Recession and Vocational Assessments: How Current
Economic Times Are Forcing Us to Rethink Our Business
John F. Berg, M.Ed, CDMS, CRC, ABVE-D
Vocational Consulting, Inc., Seattle, WA
Unemployment Rates: Authoritative resources to document
historical trends.
Decline/Demand occupations – where to find publications for
documentation purposes by job titles, corresponding job
numbers, wages, growth or loss projections.
Using multiple sources to cooborate vocational opinions.
Expressing opinions of jobs available and wages in professional
reports; Attachments, charts, and data presentations for your
foundation.
Testimony tips regarding economic changes for the Vocational
Expert.
129
Berg, Truthan, Robinson, Lessne
130
Economic Recession &
Vocational Assessments:
How Current Economic Times are
Forcing us to Rethink our Business
ABVE Conference – March 27,2011
Orlando, FL
Jeff Truthan, MS, CVE
President – SkillTRAN LLC
www.skilltran.com
Objectives
• Challenges Facing the US Economy
• “Recovery” ?
• Common Public Sources of Occupational
& Labor Market Data
• Unique Information in various Sources
• “Sedentary Unskilled” Jobs
• Labor Force Participation by PWD
• Long Term Patterns – Worker Burden
Challenges Facing the US Economy
Growth vs. Recession vs. “Recovery”
• Business Decisions [Housing / Credit Crunch]
• Imbalance of Imports vs. Exports [Weak dollar]
• Government Debt Burden
[Defense + SSA + Education + Health +
Bailouts + Economic “Stimuli”]
Increasing Costs of Doing Business
• Price of Oil / Fuel / Energy / Shipping / Transportation
• Wages
• Benefits – Workers Comp – UI - Health Care
131
Challenges Facing the US Economy
Impact of Technology
• Automation – Mechanization of processes
• Computerization
• Displacement of some workers (& Rehab)
• Opportunities for other kinds of workers
Outsourcing
• RIF/JIT employees – Subcontract / Temp Help
Manufacturing & Service Sectors
• Offshoring
8.1 million Jobs Disappear!
Slide Courtesy of Brian McMachon
Employer’s Market
132
Monthly Losses in Non Ag Payroll
12/07-09/09; M=151K/mo
"%&'%&(&)*"*
$
"#
89% of Losses in 4 of 20 Industries
&%/&3
'"+("/&3
6*((+(#&8&
9+&#(+/&3
4(/&3
56&5+"("&
6&7(((+/&3
Industry Impact (20 possible)
Four industries = 89% of all job losses
Major Industry Sector
Dec 2007
Sep 2009
Absolute Relative
Change Change
Construction
7,491
5,814
-1,677
-22.4%
Admin & Waste Mgmt
8,350
7,066
-1,284
-15.4%
Manufacturing
13,276
11,634
-1,642
-12.4%
Trade, Transpo & Utilities
26,709
24,754
-1,955
-7.3%
Service (Ed,Hlth,SocAsst)
18,559
19,247
688
3.7%
Government
22,377
22,480
103
0.5%
133
Occupational Groups Most Impacted
Absolute Relative
Change Change
Major Occupation
Sep-07
Sep-09
Constr/Trades/Laborers
9,503
7,468
-2,035
-21.4%
Production Workers
9,371
7,677
-1,694
-18.1%
Installation/Repair
5,454
4,880
-574
-10.5%
Office and Clerical
19,484
17,755
-1,729
-8.9%
Material Moving
8,823
8,145
-678
-7.7%
Sales
16,277
15,519
-758
-4.7%
-0.5%
Service
24,659
24,533
-126
Professional
30,380
30,414
34
0.1%
Managerial/Financial
21,528
21,772
244
1.1%
TOTAL
145,479
138,163
-7,316
-5.0%
Employment Situation – CPS – 1/2011
Upbeat
134
Spokane LMI Economist
Doug Tweedy
• The recession is “over”.
• Hardest hit:
Males (70%) – 60% of which are 40+ yo
37% of those out of work have a BA
50% have a High School diploma
Construction, Manufacturing, Financial, Retail Industries
• Employers often laid off 2 employees, then replaced the
two jobs with one combined job
• Bigger employers are hiring more first
• In 2 years, it will be a job seeker’s market
• Wages have not dropped.
• Avg unemployment time is 12 wks.; In Recession 22 wks.
Employment Situation – CPS – 1/2011
• 2.8 million persons were “marginally attached to the
labor force, up from 2.5 million from a year earlier.
• Of these, 1.0 million persons ( 35%) were
discouraged workers. Discouraged workers are those
not looking for work because they believe that no jobs
are available for them.
• Remaining 1.8 million had not searched for work in
the prior 4 weeks due to school attendance or family
responsibilities.
2008 Employment by
Education/Training
www.bls.gov/emp/ep_education_training.htm
135
2008 Employment by Education
Attainment
www.bls.gov/emp/ep_education_training.htm
Common Sources for Employment Data
Occupation
Employment/Industry
• JOLTS
• QCEW (ES-202)
Quarterly Census of
OOH [National Only]
Employment & Wages
Career Guide to Industry - CGI
• County Business Patterns
Current Population
US / State / County / Zip
Survey (Census CPS)
• Business Dynamics Stats
OES - Occupational
Employment Survey
• [Input/Output Matrix]
National Compensation Survey • Business Listings
Long Term Employment • Professional Associations
Projections
• Business Assn/Journals
State Labor Market
• Manufacturer Guides
Information Depts.
• DOT
• O*NET
•
•
•
•
•
•
•
Industry Classifications
SIC - 1987
0x – Agriculture
10-14 – Mining
15-17 – Construction
2x-3x – Manufacturing
4x – Transportation, Utilities
50-51 – Wholesale
52-59 – Retail
6x – Finance, Insurance, Real Estate
7x-8x – Services
9x - Public Administration [Govt.]
www.bls.gov/bls/naics.htm
11 – Agriculture
21 – Mining, Quarrying, Oil-Gas Extraction
22 – Utilities
23 – Construction
NAICS
31-33 – Manufacturing
2007
42 – Wholesale Trade
44-45 – Retail Trade
48-49 – Transportation / Warehousing
51 – Information
52 – Finance / Insurance
53 – Real Estate / Rental / Leasing
54 – Professional / Scientific / Technical
55 – Management of Companies
56 – Administrative / Support / Waste Mgmt
61 – Educational Services
62 – Health Care and Social Assistance
71 – Arts, Entertainment, Recreation
72 – Accommodation / Food Services
81 – Other Services
92 – Public Administration [Fed/State/Local Govt.]
136
Input-Output Matrix
• Built using OES, CPS, and CES data
• Constructed for long-term occ. Projections
• Covers 300+ NAICS industries and
700+ occupations
• Considers: Labor Force, aggregate
economy, final demand (GDP), industry
output, employment by industry, employment
by occupation
• Peer-reviewed by multiple govt. economists
• www.bls.gov/emp/empind3.htm
Factors Affecting Industry Output &
Employment
[ By Industry Sector]
• www.bls.gov/emp/ep_table_501.htm
Example:
Semiconductor and other electronic component
manufacturing
Output is used as an input in communications equipment, computers, and numerous
other consumer goods and manufacturing industries. It is also exported. Output is
projected to increase significantly faster than GDP, assisted by steady export growth.
Productivity growth is expected to continue at a high pace as processes continue
to be automated. Productivity growth, combined with the movement of some
research and development overseas, is expected to result in a decline in
employment. This industry is one of the fastest growing, in terms of output, over the
projection period.
OES – Long Term
Employment Projections
• Updated every two years
• Shows national projections for occupations by industry (NAICS 2007)
• Uses OES Survey data plus Current Employment Statistics (CES) and
the CPS and the I/O Matrix
• Cites 300+ NAICS industries for 700+ OES groups
• Data suppressed if < 50 workers in an industry
• 10 year projection model uses labor force, aggregate economy, final
demand (GDP), industry output, employment by industry, and
employment by occupation
• www.bls.gov/emp/home.htm
137
Fastest Growing and
Declining Industries
Employment Projections – Bureau of Labor Statistics
www.bls.gov/emp/ep_table_204.htm
List of all NAICS 2007 Codes & Titles
http://www.census.gov/naics/2007/NAICOD07.HTM
County Business Patterns
• Counts of business by NAICS – 6 digits
• Gathered from income tax data, excluding: the
self-employed, farm workers, government
workers, railroad workers
• Not a sample – this is all firms with employees
• Breakouts by size classes (N employees)
• Available for US, County, MSA, Zip Code
• Two year lag time in availability (mid-year)
• www.census.gov/econ/cbp/index.html
Business Dynamics Statistics
•
•
•
•
•
•
•
•
New tool –Investigates a changing economy
Reports firm age and firm size using longitudinal data
Public-use data
# Establishments / Openings & Closings
Employment
Job Creation-Expansion / Destruction-Contraction
Annual data 1976-2005
SIC-based Industries
• www.ces.census.gov/index.php/bds/bds_overview
138
State Labor Market
Information Sources
• Should be available on web for most states
• Check here for your state:
www.bls.gov/bls/ofolist.htm
LMI Guide - 2011
Sedentary Unskilled DOT Occs
Estimates by DOT Industry
139
Employment, Hours, and Earnings from the Current Employment Statistics survey (National)
Footwear Mfg Stats
Industry:
NAICS Code:
Data Type:
Years:
Footwear
3162
ALL EMPLOYEES, THOUSANDS
1990 to 2009
$ QQXDO
Total Employme nt - Footwe ar Mfg.
90
80
70
60
50
40
30
20
10
2006
S1
2008
2002
Year
2004
1998
2000
1994
1996
1990
0
1992
<HDU
Thousands of
Workers
Total Employment - Sporting & Athletic Goods
80.0
70.0
60.0
50.0
40.0
30.0
20.0
Annual
2 01 0
2 0 08
2 0 04
2 0 06
20 00
20 02
19 9 8
19 9 6
19 9 4
1 99 0
0.0
1 99 2
10.0
Total Employment - Fabrication, NEC
800.0
700.0
600.0
500.0
400.0
S1
2010
2008
2006
2004
2002
2000
1998
1996
1992
1994
200.0
100.0
0.0
1990
300.0
140
Total Employment - Hat & Cap
(All Other Apparel Mfg
S1
2010
2008
2006
2002
2004
1998
2000
1994
1996
1992
1990
160.0
140.0
120.0
100.0
80.0
60.0
40.0
20.0
0.0
Total Employment - Pen, Pencil, Button, Notion
250.0
200.0
150.0
100.0
2010
2008
2006
2004
2002
1998
2000
1994
1996
1992
0.0
1990
50.0
S1
Totatl Employment - Textile Mfg.
140.0
120.0
100.0
80.0
60.0
40.0
S1
2010
2008
2004
2006
2002
1998
2000
1996
1994
1992
0.0
1990
20.0
141
S1
2010
2006
2008
2004
2000
2002
1998
1994
1996
1990
45.0
40.0
35.0
30.0
25.0
20.0
15.0
10.0
5.0
0.0
1992
Total Employment - Tobacco Mfg.
Total Employment - Knitting
160.0
140.0
120.0
100.0
80.0
60.0
2008
S1
2010
2006
2004
2000
2002
1996
1998
1994
1990
20.0
0.0
1992
40.0
Sedentary – Unskilled Occupations
• There are 137 sedentary unskilled DOT occs
• These occupations are distributed across 38 different
OES groups. This is 4.7% of the 801 OES groups
• 113,000 of the estimated employment numbers
(Industry Context method) cluster in 6 DOT
occupations
• The remaining 73,937 estimated employed were
spread across 131 DOT titles
• These DOT occupations cover 45 DOT industries
• Influence of rehabbers/occupational health
• See the handout spreadsheet for the details –
By Industry Group and by Frequency
142
Sedentary Unskilled DOT Occs
Estimates by Frequency
Sedentary – Unskilled DOT Occs
Simple Math vs. Industry Context
• SkillTRAN Industry Context method estimates
less than 200,000 employed
• Simple Math estimates about 700,000
• Simple Math overestimates the employment of
Sedentary Unskilled Occupations by about 350%
'HWHUPLQLQJ([LVWHQFH
RI2FFXSDWLRQV
1. Review available LMI for specific occupations.
This may include some industry suggestions.
2. Determine which industries might hire for the
occupation(s) in question.
3. Identify businesses in those industries within
the client’s personal Labor Market Area.
4. Do Labor Market Sampling.
143
/DERU0DUNHW6DPSOLQJ
• Establishes existence / frequency of jobs
• Clarifies complex disability/cultural issues
• Can validate hiring history / future hiring /
turnover rate for that occupation
• Can establish starting / average wages
• Adequate random sampling can be
extrapolated to reasonably estimate industry
employment in a given labor market area
• Builds a more reliable, defensible foundation
upon which to develop an opinion or plan
L.F. PARTICIPATION RATE (%)
80
78 %
70
60
50
40
W DIS
WO DIS
36 %
30
20
10
0
OFFICIAL UNEMPLOYMENT x AGE (%)
35
30
25
20
NDIS
15
DIS
10
5
0
1619
20- 25- 3024 29 34
35- 45- 5544 54 64
144
Reasons for Non-participation
3
;3
3
Note: what’s not the problem?
;3
3
3
;3
;3
;3
;
3
3
;3
;3
3
;3
3
;
3
;3
;3
;3
;3
3
<"&$*6
'"6(("+
<=&=(+
$(+(*((" *(&>&'%(6
'
?+"+((((+
9(%&$(+((
%""&>
5((
@%&>
$(+((
5+"("
9(%"&$(+((
Total Employment (Thousands)
Historical Employment
140000
Year Employment
1990
109487
1991
108375
1992
108726
1993
110844
1994
114291
1995
117298
1996
119708
1997
122776
1998
125930
1999
128993
2000
131785
2001
131826
2002
130341
2003
129999
2004
131435
2005
133703
2006
136086
2007
137598
2008
136790
2009
130807
2010
129819
120000
100000
80000
60000
40000
20000
2008
2010
2006
2002
2004
1998
2000
1994
1996
1990
1992
0
Population Growth vs. Labor Force (Thousands)
350000
Population vs. Employment
300000
250000
200000
“Pain” Ratio
150000
Worker Burden
N Employed
Population
100000
50000
2010
N Employed
2008
2004
2006
2000
2002
1998
1994
1996
1990
1992
0
145
Labor Force Reserve Ratio
3
;3
3
3
3
3
;
3
3
3
3
3
9(%&$(+((
9(%"&$(+((
The Future
• Creation of new jobs will occur slowly and
cautiously (“Just-In-time Hiring”)
• Temp jobs are the new way “in” to many
employers (Conversion from temp to
permanent – depends on the industry)
• Multiple skill sets will be required
(Greater worker versatility)
• As the size of the non-disabled labor force
decreases due to aging and retirement, more
opportunities should emerge for PWD
7KDQNV WR%ULDQ0F0DKRQ3K'
IRUVKDULQJVRPHVOLGHV
Jeff Truthan
jtruthan@skilltran.com
www.skilltran.com
(800) 827-2182
146
147
OOH
CGI
CPS
OES
NCS
I-O Matrix
LTEP
OPTD
JOLTS
CES
CBP
BDS
X
X
X
X
X
X
SOC/OES
NAICS
X
X
X
X
X
X
X
Median
X
SOC/OES
NAICS
X
US
750+
2 yrs
OPTD
www.projectionscentral.com
X
X
X
X
X
X
X
X
SOC/OES
NAICS
X
US
700+
2 yrs
LTEP
Statewide Occupational Projections
X
X
X
X
X
X
By Occ Level
SOC/OES
SOC/OES
NAICS
X
X
X
US
0
2 yrs
US
Metro
Non-Metro
800
Varies
US, State
Regional
801
1 yr
X
I-O Matrix
NCS
OES
Web URL:
www.bls.gov/oco/home.htm
www.bls.gov/oco/cg
www.bls.gov/cps
www.bls.gov/oes
www.bls.gov/NCS
www.bls.gov/emp/empind3.htm
www.bls.gov/emp/home.htm
www.bls.gov/emp/optd/home.htm
www.bls.gov/jlt
www.bls.gov/ces
www.census.gov/econ/cbp/index.html
www.ces.census.gov/index.php/bds/bds_overview
X
X
X
X
X
X
X
X
X
X
X
X
X
SOC / OES
O*NET
NAICS
X
X
US
503
10 yr / 1 yr
CPS
X
X
US
75%
2 yrs
CGI
Resource
Occupational Outlook Handbook
Career Guide to Industries
Current Population Survey
Occupational Employment Survey
National Compensation Survey
Input-Output Matrix
Long Term Employment Projections
Occupational Projections and Training Data
Job Openings and Labor Turnover Survey
Current Employment Statistics
County Business Patterns
Business Dynamics Statistics
X
X
X
X
X
By Occupations
Employment Numbers
Wages
Long Term Outlook
By Industry
Employment Numbers
Wages
Long Term Outlook
Long Term History
Education Requirements
Age Distribution
Full-Time / Part-Time / Self-Employment
Hours Worked
Gender
Union Affiliation
Employee Absence
Benefits
Job Openings
Job Creation / Destruction
Business Estimates (N establishments)
by N employees in size ranges
by Firm Age (N years in business)
X
O*NET
X
X
US
400
2 yrs
Related Sites
Cross References
Orientation
Client
Professional
Coverage
N Occupations
Update Frequency
OOH
Courtesy of SkillTRAN LLC - 2011
Labor Market Information - Resources Guide
X
X
Payroll
NAICS
X
X
Payroll
NAICS
X
US, State
County
ZIP
0
1 yr
US, State
County,
MSA
0
12x/yr
X
CBP
CES
X
X
X
X
X
X
NAICS
X
BDS
Some reporting delays (older data)
Comments:
Narrative Format - Also see OOQ
Covers 44 Major Industry Groups
Self-Reported Data by large occupational groups
Employer-Reported Comprehensive Data
Occupational Levels - Employer Cost & Trends
Bureau of Economic Analysis
10 Year Occupation/Industry Projections
Excellent info re: Education Attainment
? Reliability vs. CES
No occupational detail - workforce size
2 year reporting lag - Universe not sample
Up to 5 year reporting delay - new universe data set
X
X
NAICS
X
US
Regional
0
1 yr
JOLTS
148
108375
108726
110844
114291
117298
119708
122776
125930
128993
131785
131826
130341
129999
131435
133703
136086
137598
136790
130807
129819
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Source: Bureau of Labor Statistics
109487
1990
308745
307006
304374
301593
298753
295753
293045
290326
287803
285081
281422
277840
274632
271394
268108
264927
261713
258445
254929
2.38
2.35
2.23
2.19
2.20
2.21
2.23
2.23
2.21
2.16
2.14
2.15
2.18
2.21
2.24
2.26
2.29
2.33
2.34
0
50000
100000
150000
200000
250000
300000
350000
Population Growth vs. Labor Force (Thousands)
1998
1996
1994
2.32
2000
2.26
2002
251090
2004
247982
2006
CEU0000000001
Series Id:
Not Seasonally Adjusted
Super Sector:
Total nonfarm
Industry:
Total nonfarm
NAICS Code:
Data Type:
ALL EMPLOYEES, THOUSANDS
1990 to 2010
Years:
"Pain"
Year
N Employed Population
Ratio
N Employed
Population
Generated on: February 9, 2011 (05:23:36 AM)
2008
Employment, Hours, and Earnings from the Current
Original Data Value
Bureau of Labor Statistics
2010
N Employed
1992
1990
149
DOT
219587010
349665010
782687046
690686046
690686066
788687022
788687114
788687158
788687166
237367014
249587014
249587018
673685042
690685194
692685130
692685206
692685266
734684010
734687010
734687018
734687034
734687058
734687074
734687086
734687090
734687094
740687010
521687010
521687086
205367014
209587010
239687014
615685014
715684010
715684026
715684082
715684138
715684146
715684178
715685038
715685050
715687010
715687018
715687022
715687026
715687078
715687082
Title
PARIMUTUEL-TICKET CHECKER (amusement/recreation)
SCOREBOARD OPERATOR (amusement/recreation)
SACK REPAIRER (any industry)
PLASTIC-DESIGN APPLIER (boot & shoe)
TOGGLE-PRESS FOLDER-AND-FEEDER (boot & shoe)
BUCKLER AND LACER (boot & shoe)
SHANK TAPER (boot & shoe)
VAMP-STRAP IRONER (boot & shoe)
WHITE-SHOE RAGGER (boot & shoe)
CALL-OUT OPERATOR (business services)
CUTTER-AND-PASTER, PRESS CLIPPINGS (business services)
DOCUMENT PREPARER, MICROFILMING (business services)
CONVEX-GRINDER OPERATOR (button & notion)
GRINDING-MACHINE OPERATOR, AUTOMATIC (button & notion)
PINKING-MACHINE OPERATOR (button & notion)
STOP ATTACHER (button & notion)
ZIPPER TRIMMER, MACHINE (button & notion)
FEATHER SHAPER (button & notion)
ACETONE-BUTTON PASTER (button & notion)
ASSEMBLER (button & notion)
BUCKLE-WIRE INSERTER (button & notion)
HOT-STONE SETTER (button & notion)
SLIDE-FASTENER-CHAIN ASSEMBLER (button & notion)
SPLITTER, HAND (button & notion)
STICKER (button & notion)
ZIPPER TRIMMER, HAND (button & notion)
BUTTON SPINDLER (button & notion)
ALMOND BLANCHER, HAND (canning & preserving)
NUT SORTER (canning & preserving)
CHARGE-ACCOUNT CLERK (clerical)
ADDRESSER (clerical)
TUBE OPERATOR (clerical)
CLEARANCE CUTTER (clock & watch)
ADJUSTER, ALARM MECHANISM (clock & watch)
BENCH HAND (clock & watch)
DIAL-SCREW ASSEMBLER (clock & watch)
LACQUERER (clock & watch)
OILER (clock & watch)
SET-STAFF FITTER (clock & watch)
MAINSPRING WINDER AND OILER (clock & watch)
PRESS OPERATOR, PIERCE AND SHAVE (clock & watch)
BAND ATTACHER (clock & watch)
CRYSTAL ATTACHER (clock & watch)
DIAL BRUSHER (clock & watch)
DIPPER, CLOCK AND WATCH HANDS (clock & watch)
MAINSPRING FORMER, ARBOR END (clock & watch)
MAINSPRING FORMER, BRACE END (clock & watch)
Strength
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
SVP
2
2
2
1
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
1
2
2
2
1
2
2
1
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
RML
333
323
211
111
111
111
111
111
111
323
211
312
211
212
212
212
211
212
111
111
111
111
211
111
111
222
111
111
111
323
212
212
211
212
111
212
111
211
211
211
211
111
111
111
111
212
211
ESTIMATED EMPLOYMENT NUMBERS USING SKILLTRAN METHODOLOGY
Grouped by OES & Industry
BASIS: OES - May, 2008 Data & Long Term Industry Projections (2008-2018), Adjusted for 2010
O*NET
43-3031.00
27-2023.00
51-6031.02
53-7063.00
53-7063.00
51-9198.01
51-9198.01
51-9199.99
51-9123.00
43-4041.02
43-9061.00
43-9061.00
51-9021.00
51-9021.00
51-9032.04
51-9199.99
51-9032.04
51-9199.99
51-9199.99
51-9199.99
51-9199.99
51-9199.99
51-9199.99
51-9031.00
51-9199.99
51-9061.05
51-9123.00
51-9198.01
51-9061.05
43-4111.00
43-9022.00
43-5021.00
51-4031.02
51-9199.99
51-9199.99
51-9199.99
51-9123.00
51-9199.99
51-9199.99
51-9199.99
51-4031.03
51-9199.99
51-9199.99
51-9199.99
51-9123.00
51-9199.99
51-9199.99
DOT Industry
amusement/recreation
amusement/recreation
any industry
boot & shoe
boot & shoe
boot & shoe
boot & shoe
boot & shoe
boot & shoe
business services
business services
business services
button & notion
button & notion
button & notion
button & notion
button & notion
button & notion
button & notion
button & notion
button & notion
button & notion
button & notion
button & notion
button & notion
button & notion
button & notion
canning & preserving
canning & preserving
clerical
clerical
clerical
clock & watch
clock & watch
clock & watch
clock & watch
clock & watch
clock & watch
clock & watch
clock & watch
clock & watch
clock & watch
clock & watch
clock & watch
clock & watch
clock & watch
clock & watch
ESTIMATED EMPLOYMENT
US
State
Region
1,670
1,747
1,077
n/a
1,135
5
5
27
30
11,999
5,917
23,195
189
189
174
50
99
6
n/a
n/a
n/a
n/a
577
33
326
1,627
993
292
2,526
16,773
5,653
197
32
32
32
10
46
46
46
262
32
32
32
10
46
46
150
715687086
715687090
715687094
715687098
715687114
770687026
779684034
729684018
17684010
726684050
726684110
726685066
726687030
726687046
706684030
731687014
739684094
739684162
739685046
739685050
739685054
739687182
754684018
237367046
692685254
739687086
779687018
779687038
782687030
205367030
379367010
784684030
784687026
209567014
723687010
652685038
700687026
700687062
735687018
735687022
735687034
739687066
585665010
685687014
685687026
734687042
690685258
725684018
725687022
654687014
979687026
MASKER (clock & watch)
MOTOR POLARIZER (clock & watch)
MOUNTER, CLOCK AND WATCH HANDS (clock & watch)
PAINTER, CLOCK AND WATCH HANDS (clock & watch)
ROTOR ASSEMBLER (clock & watch)
JEWEL STRINGER (clock & watch)
LEVEL-VIAL SEALER (cutlery-hardware)
DIAL MARKER (electrical equipment)
TAPER, PRINTED CIRCUIT LAYOUT (electronic component)
FILM TOUCH-UP INSPECTOR (electronic component)
TOUCH-UP SCREENER, PRINTED CIRCUIT BOARD ASSEMBLY (electronic component)
BONDER, SEMICONDUCTOR (electronic component)
LOADER, SEMICONDUCTOR DIES (electronic component)
WAFER BREAKER, SEMICONDUCTORS (electronic component)
ATOMIZER ASSEMBLER (fabrication, nec)
FINISHER (fabrication, nec)
LAMP-SHADE ASSEMBLER (fabrication, nec)
UMBRELLA TIPPER, HAND (fabrication, nec)
TAPPER, BIT (fabrication, nec)
TAPPER, SHANK (fabrication, nec)
UMBRELLA TIPPER, MACHINE (fabrication, nec)
TABLE WORKER (fabrication, nec)
BIT SHAVER (fabrication, nec)
TELEPHONE QUOTATION CLERK (financial)
WINDOW-SHADE-RING SEWER (furniture)
EYE-DROPPER ASSEMBLER (glass products)
GLASS-BULB SILVERER (glass products)
WAXER (glass products)
PULLER-THROUGH (glove & mitten)
ELECTION CLERK (government services)
SURVEILLANCE-SYSTEM MONITOR (government services)
FOUNDATION MAKER (hat & cap)
ENDBAND CUTTER, HAND (hat & cap)
ORDER CLERK, FOOD AND BEVERAGE (hotel & restaurant)
PATCHER (household appliances)
INK PRINTER (jewelry-silverware)
CHARGER II (jewelry-silverware)
PREPARER (jewelry-silverware)
PAINTER (jewelry-silverware)
PIN-OR-CLIP FASTENER (jewelry-silverware)
STONE SETTER (jewelry-silverware)
COMPACT ASSEMBLER (jewelry-silverware)
NAPPER TENDER (knitting)
CUFF FOLDER (knitting)
TOPPER (knitting)
BUTTON RECLAIMER (knitting)
LAMINATOR I (leather products)
STEM MOUNTER (light fixtures)
GETTERER (light fixtures)
PAGER (machinery mfg.)
TYPE-COPY EXAMINER (machinery mfg.)
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
1
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
111
111
111
111
212
211
211
222
222
211
212
212
212
212
211
211
211
211
211
211
111
111
211
323
211
211
111
111
111
322
313
212
211
312
211
212
211
211
212
211
111
211
211
111
111
111
211
211
111
211
212
51-9123.00
51-9198.01
51-9199.99
51-9123.00
51-9199.99
51-9198.01
51-9199.99
51-9123.00
51-9199.99
51-9061.05
51-9061.05
51-4199.99
51-9141.00
51-9141.00
51-9199.99
51-9199.99
51-9199.99
51-6051.00
51-4199.99
51-9199.99
51-9199.99
51-9061.05
51-9022.00
43-4171.00
51-6031.02
51-9199.99
51-9123.00
51-9198.01
51-9198.01
43-9061.00
33-9099.99
51-9199.99
51-9031.00
43-4151.00
51-9199.99
51-5023.09
51-9199.99
51-9199.99
51-9123.00
51-9199.99
51-9199.99
51-9199.99
51-9199.99
51-9198.01
51-9199.99
51-9061.05
51-9041.02
51-2022.00
51-9199.99
51-9199.99
51-9061.05
clock & watch
clock & watch
clock & watch
clock & watch
clock & watch
clock & watch
cutlery-hardware
electrical equipment
electronic component
fabrication, nec
fabrication, nec
fabrication, nec
fabrication, nec
fabrication, nec
fabrication, nec
fabrication, nec
fabrication, nec
fabrication, nec
financial
furniture
glass products
glass products
glass products
glove & mitten
government services
government services
hat & cap
hat & cap
hotel & restaurant
household appliances
jewelry-silverware
jewelry-silverware
jewelry-silverware
jewelry-silverware
jewelry-silverware
jewelry-silverware
jewelry-silverware
knitting
knitting
knitting
knitting
leather products
light fixtures
light fixtures
machinery mfg.
machinery mfg.
10
155
46
10
148
148
n/a
n/a
414
1,492
1,836
19
1,010
1,010
113
365
24
97
863
n/a
n/a
2,932
820
6,059
390
55
78
2,170
12
22,779
11,785
191
21
1,627
64
13
9
9
18
9
9
9
191
45
393
401
1,797
1,662
355
36
466
151
700687018
579684022
919663022
585685062
683687018
574685010
774687014
713684038
713687018
713687026
713687034
716687030
694686010
737587010
737687026
737687126
539485010
733685026
559687014
559687034
976684018
775687022
712687018
712687034
529665014
214587010
221587042
681685030
689585018
789687022
789687174
529666014
529685058
529687138
920687030
731685014
732587010
732684062
669687014
The 137 Sedentary Unskilled DOT occupations are found in 38 different OES groups.
In May 2008 - the US National total using May 2007 data adjusted for 2008 was 200,150
In Feb 2009 - the US National total using May 2007adjusted for 2009 was 197,357
In Sept 2009 - the US National total using May 2008 adjusted for 2009 was 193,497
In March 2010 - the US National total using May 2008 adjusted for 2010 was 186,936
BRIMER (metal products, othe)
MICA-PLATE LAYER, HAND (mine & quarry)
ESCORT-VEHICLE DRIVER (motor transportation)
LABEL PINKER (narrow fabrics)
HANDER-IN (narrow fabrics)
COATER, BRAKE LININGS (nonmetallic mineral)
LACER (nonmetallic mineral)
POLISHER, EYEGLASS FRAMES (optical goods)
FINAL ASSEMBLER (optical goods)
LENS INSERTER (optical goods)
POLISHER, IMPLANT (optical goods)
LENS-BLOCK GAUGER (optical goods)
CLIP-LOADING-MACHINE FEEDER (ordnance)
BANDOLEER STRAIGHTENER-STAMPER (ordnance)
CHECK WEIGHER (ordnance)
SHADOWGRAPH-SCALE OPERATOR (ordnance)
WEIGHT TESTER (paper & pulp)
SMOOTHER (pen & pencil)
AMPOULE SEALER (pharmaceuticals)
EGG PROCESSOR (pharmaceuticals)
MOUNTER, HAND (photofinishing)
GOLD BURNISHER (pottery & porcelain)
GAUGER (protective devices)
SUTURE WINDER, HAND (protective devices)
WASHROOM OPERATOR (sugar & confection)
TELEGRAPH-SERVICE RATER (telephone/telegraph)
WEAVE-DEFECT-CHARTING CLERK (textile)
CARDING-MACHINE OPERATOR (textiles, other)
STRINGING-MACHINE TENDER (textiles, other)
BUFFING TURNER-AND-COUNTER (textiles, other)
THREAD SEPARATOR (textiles, other)
CIGARETTE-MAKING-MACHINE CATCHER (tobacco)
CIGAR-HEAD PIERCER (tobacco)
LEAF TIER (tobacco)
BANDER, HAND (tobacco)
STUFFER (toy-sport equipment)
GOLF-BALL TRIMMER (toy-sport equipment)
FISHING-REEL ASSEMBLER (toy-sport equipment)
DOWEL INSPECTOR (woodworking)
NOTES:
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
S
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
1
2
2
2
2
2
111
211
212
211
211
212
211
211
111
111
211
212
111
111
111
212
333
211
211
211
211
211
212
211
211
222
212
111
212
111
111
212
211
111
211
211
211
211
111
51-9199.99
51-9199.99
53-3033.00
51-6062.00
51-9198.01
51-9121.02
51-9199.99
51-4033.02
51-9199.99
51-9199.99
51-9022.00
51-9061.05
53-7063.00
51-9198.01
51-9061.05
51-9061.05
51-9061.05
51-4033.02
53-7064.00
51-9199.99
51-9031.00
51-9022.00
51-9061.05
51-9198.01
51-9192.00
43-3021.02
43-5061.00
51-6064.00
51-9199.99
51-9199.99
51-9198.01
51-9061.05
51-9199.99
53-7062.03
53-7064.00
51-9111.00
51-9199.99
51-9199.99
51-9061.05
TOTAL
metal products, othe
mine & quarry
motor transportation
narrow fabrics
narrow fabrics
nonmetallic mineral
nonmetallic mineral
optical goods
optical goods
optical goods
optical goods
optical goods
ordnance
ordnance
ordnance
ordnance
paper & pulp
pen & pencil
pharmaceuticals
pharmaceuticals
photofinishing
pottery & porcelain
protective devices
protective devices
sugar & confection
telephone/telegraph
textile
textiles, other
textiles, other
textiles, other
textiles, other
tobacco
tobacco
tobacco
tobacco
toy-sport equipment
toy-sport equipment
toy-sport equipment
woodworking
186,936
651
125
26,469
2,695
216
3,116
30
2,213
n/a
n/a
1,172
666
138
394
176
176
109
968
1,579
152
n/a
166
666
665
n/a
209
122
174
13
13
50
12
529
105
13
3,661
n/a
n/a
113
-
152
Multicultural
Medical & Vocational Case Management
~Ethical & Legal Considerations~
Barbara Berndt,, M. Ed,,
CRC, CDMS, CCM, ABVE
Bilingual Counselor
March 27, 2011
People are People
z
z
Introduction: CRC D.5 (h) Personal Public Statement
Counselor Competencies
–
CRC Standards & requirements
q
for cultural competencies
p
and/or diversity
–
CDMS Human relations relating to culture
z
z
–
A 2 (a), (b); A 3 (c); B 1 (a); D 1 (a); D 2 (a), (b)
RPC 1.13 (a)
CCM Underlying Values
z
z
Autonomy, beneficience, nonmalficence, justice
Selected definitions: advocacy, beneficience, client, justice,
monitoring, nonmaleficence, planning.
Client Population/Background
z
z
z
z
z
Refugees & War-related Populations
Political Violence
SocioEconomic Upheaval
Changing Demographics
Other
153
Berndt
Multicultural Values & Beliefs
z
Cultural Sensitivity - Autonomy Ethics
z
Cultural Implications
p
–
–
–
–
z
Language, religious/spiritual beliefs
Ways of thinking
Patterns of social relations
Cultural Orientation
–
–
–
z
Attitudes and beliefs
Collective
Matriarchal or patriarchal
Individualistic
Multicultural Perspectives (examples)
Cultural Care Theory
z
z
z
z
z
Words & Language
Allopathic, Naturopathic, Shaman
P h l i l P
Psychological,
Psychiatric,
hi t i Eld
Elder
Beliefs & Values
Integration of all factors relevant to the
people to be served.
Adaptive Counseling Techniques
z
Understanding Multicultural Issues - Beneficence
–
–
–
–
z
CRC A.1.(a): avoid values imposition and (b): awareness of
own values, attitude, belief, & behaviors
CDMS PRC 1.09:
1 09: objectivity
CDMS RPC 1.13 (2) adaptive interventions that are not (3)
discriminatory
CCM: Underlying Values / Sel. Definitions: Veracity
Disclosure
–
–
–
CRC A.3. (a): Client Rights & Disclosure and (b) Informed
Consent
CMDS RPC 1.04 Description of Services and 2.03
Confidentiality
CCM IV Ethical Issues and Section 3 S 10 Description of
Services & S 15 Disclosure
154
Berndt
LAWS & LEGAL ISSUES
z
Medical Questions
z
Vocational Questions – Non-Malfeasance
z
Disability System vs State/National Laws
–
–
–
–
–
Ability to receive treatment/services
Barriers to employment
Seek & Find Answers ~~ Changing Requirements
CDMS RPC 1.21 (e) Ethical Practice
CRC Advisory Opinion
Understanding Your Client
z
Understanding of Cultural Identity
–
–
–
Person
Extended family
Neighborhood / Community
z
Integration
z
Immigration Knowledge/Stages
–
–
–
–
How person makes decisions about health, illness & healing
Pre-migration
Transitions
Re-settlement
Case Management Interview
z
z
z
Introduction & Involvement of Other(s)
Observation
Obtaining Information/Adaptive Techniques
–
–
–
Strengths
Coping Strategies
Resiliencies
z
Determining Adjustment to Disability Issues
z
Discussion of Disability Issues
z
Setting Foundation for Assessment/Services
–
–
What I think
What S/he/they think
155
Berndt
Medical & Vocational
Case Management
z
Work within Ethical Guidelines
–
–
z
Unconditional Positive Regard
–
–
z
Transcultural Ethical Theory
Diversity of Cultural, Beliefs & Values
Defining Boundaries
–
–
–
z
Personal – Professional Boundaries: transference/countertranference
Secondary Traumatization
CRC B 1 Respecting Client Rights (c) For Confidentiality, (d) Limits, and
B.2. (a) Legal Requirements and (d) Minimal Disclosure
CDMS RPC 1.05 Legal Compliance
CCM 4 S14 Legal Compliance
Empowering the Client’s Perception- Justice
Case Management Review
z
z
z
z
Define roles, expectations & goals
Engage in defining mutual expectations
Encourage participation
When In Doubt: challenge or change the
system
–
CRC Advisory Opinion #88
Professional Resources
z
Changing Your Own Knowledge Base
–
–
–
z
CRC D.1. Professional Competence (b) new speciality, (c)
qualifed, and (e) continuing education
CMDS RPC 1.21 (b) Professional Growth & Development
CCM S. Representation of Practice, S3 Competence
Advisory Opinions:
–
CRC #’s 25, 28, 34, 65, 86, 88, 89, 92, 102
156
Berndt
Conclusion of Services
z
z
z
Fair & Balanced Provision of Services - Fidelity
Reinforce Plan of Action
Termination of Services
–
Acknowledgement, Gifts, Invitations
Case Specifics in My Practice
z
Professional Competencies:
z
Testing
–
–
–
Interpreters/Translators (CRC A.3.(c) & B3.d)
(CRC G.7. Test Scoring/Interpretation)
Neuropsychological
ESL
z
“Client” Responsibility (CRC B.5. (b) Parent)
z
Perfect Solutions are Impossible
Resources
z
z
z
z
z
Continuing Education
Websites
Community Agencies
Networking with Professionals
Build Relationships with Stakeholders in
Ethnic Minority Communities
157
Berndt
Questions & Answers
Thank you!
Gracias!
Merci!
Grazie!
Barbara Berndt, M.Ed, CRC, CDMS, CCM, ABVE
irc4rehab@comcast.net
www.expertvocational.com
158
Berndt
Notes