Unique Rehabilitation Aspects of Care for People with Disabilities and Chronic Illness

✅ Reviewed for accuracy and relevance by Deanna Cooper Gillingham, RN, CCM, FCM on July 11, 2025.

Job analysis

Job analysis is a process to identify, in detail, the essential duties and requirements for a given job, and their relative importance. It focuses on the job itself, not the person occupying the role (Chapin et al., 2018). 

Data is collected to determine the essential job functions and the physical, cognitive, and behavioral capacities required to perform the job. The most obvious functions are those that the position exists to perform. For example, a cashier’s obvious job function is to exchange money with customers.

The job analysis enables the development of a training plan, work modification, or reasonable accommodation for the individual that will make it possible for them to fulfill the requirements of the job.

Job modification/job accommodation

Job modifications and accommodations include any change in the environment or how tasks are customarily completed that enables a Person with Disability (PWD) to perform the task or accomplish a goal (Chapin et al., 2018). The terms job modification and job accommodation are often used interchangeably, but they are different. A job modification is an across-the-board change to the job description or how tasks are done, targeting skills. Examples include restructuring the job, eliminating marginal job functions, sharing job duties, or modifying company policy. Job accommodations are individualized and focus on access, such as voice recognition software or a desk that rises to accommodate a wheelchair. Because much of the literature and most case managers use the terms interchangeably, we will use the term accommodation for the remainder of this section. 

Job accommodation process:

  1. Request accommodation: The PWD is responsible for requesting an accommodation.
  2. Identify functional limitations: Determine where the functional limitations intersect with the job duties; that is, which tasks the PWD cannot perform without accommodation.
  3. Identify accommodations: Discuss options with the employee. Often, the accommodation is obvious, or something the employee has used successfully before, but creative collaboration, extensive investigation, or outside assistance may be needed.
  4. Determine reasonable solutions: The ADA requires employers to provide reasonable accommodations for qualified applicants or employees with disabilities unless doing so would cause undue hardship for the employer. Undue hardship can refer to accommodations that cause financial difficulty, are disruptive to the workplace, or fundamentally change the operation of the business.
  5. Make accommodations: While the employee’s preferences should be considered, the employer will determine which accommodations are implemented based on cost, business feasibility, and effectiveness.
  6. Monitor effectiveness: If the desired outcome is not achieved, the employee and the employer should restart the process.

The Job Accommodations Network (JAN) is a consulting service provided by the U.S. Department of Labor’s Office of Disability Employment Policy (ODEP) that provides free information on job accommodations. More than half of all accommodations cost nothing, and most of the rest cost less than $500. Tax incentives and funding through several organizations are available to help offset the expense.

Accommodations are not limited to adjustments or modifications of physical equipment. The ADA lists six categories of accommodations:

  • Job restructuring – adjustments to work procedures
  • Assistive devices – equipment that helps the employee complete the task
  • Training – helps an employee learn or relearn job duties
  • Personal assistant – a person who helps an employee with job duties
  • Building modification – alterations to the physical environment that allow equal access to the facility
  • Job reassignment – temporary or permanent transfer of task assignment or sharing jobs with other employees

Supported employment

Supported employment is paid, competitive employment in an integrated workplace setting, with ongoing support for individuals with the most severe disabilities. (Disabilities here may include psychiatric, intellectual, or severe learning disabilities, traumatic brain injury, deafness or blindness, or extreme mobility impairment, among others). 

Work adjustment training

Work adjustment training focuses on attitude, behavior, and social skills for clients with behavioral health issues. Work adjustment can be done individually or in a group setting. Actual or simulated work activity is performed under close supervision at a rehabilitation facility or work setting. The goal is to improve problems that prevent the client from obtaining employment, such as attendance, punctuality, hygiene, or interpersonal relationship skills. 

Life care planning

Life care planning is an advanced practice for evaluating, coordinating, and monitoring necessary services, ensuring individuals with significant disabilities or illnesses receive comprehensive and coordinated lifelong care.

This article shares a portion of the information covered on this topic in CCM Certification Made Easy, 4th Edition by Deanna Cooper Gillingham, RN, CCM, FCM (2025). For more details on this topic and related concepts, purchase your copy at CCMCertificationMadeEasy.com.

References

Chapin, M., McCarthy, H., Shaw, L., Bradham-Cousar, M., Chapman, R., Nosek, M., Peterson, S., Yilmaz, Z., & Ysasi, N. (2018). Disability-related counseling competencies. American Rehabilitation Counseling Association, a division of ACA. https://arcaweb.org/wp-content/uploads/2023/12/ARCA-Disability-Related-Counseling-Competencies.pdf

This article shares a portion of the information covered on this topic in CCM Certification Made Easy, 4th Edition by Deanna Cooper Gillingham, RN, CCM, FCM (2025). For more details on this topic and related concepts, purchase your copy at CCMCertificationMadeEasy.com.