Better VR

What is Vocational Rehabilitation?

VR, often shortened to voc rehab, is the program that helps the disabled, d/Deaf/hard-of-hearing, and blind and low-vision (along with people who have sensory deficits in both vision and hearing) get and keep employment. For retired military members, Veteran Readiness and Employment (VR&E) (Formerly known as Vocational Rehabilitation and Employment) and the GI Bill serves them.

VR’s History

In America, the first customers of VR were veterans of World War I. Later, people with physical disabilities—the original employees of sheltered workshops—left the workshops, and pursued vocational rehabilitation in the community. A sheltered workshop is a place that employs disabled people separately from the rest of the community.

My VR counsellor used to go into sheltered workshops and promote state-funded vocational rehabilitation.

What is a Sheltered Workshop?

“The term sheltered workshop refers to an organization or environment that employs people with disabilities separately from others, usually with exemptions from labor standards, including but not limited to the absence of minimum wage requirements.”

– from Google AI, February 2025

What is Supported Employment?

Supported employment refers to service provisions wherein people with disabilities, including intellectual disabilities, mental health, and traumatic brain injury, among others, are assisted with obtaining and maintaining employment. Supported employment is considered to be one form of employment in which wages are expected, together with benefits from an employer in a competitive workplace, though some versions refer to disability agency paid employment. Companies such as Skilcraft in the United States are an example of “supported employment” which is defined in law for state and federal reimbursements (by person not by agency or corporation).

Citation: “Supported Employment.” Wikipedia. Wikimedia Foundation, 12 July 2026.      Web. 16 Aug. 2026.

Usage of Vocational Rehabilitation Services

I am currently a customer of the Washington state SeaTac office. I have been a customer since 2018. I was a customer of the Cincinnati, Ohio VR office from Friday, July 24, 2009 until about June 25, 2010. I had asked my case-worker at Hamilton County Developmental Disabilities services office about how to fill out a Plan to Achieve Self-Sufficiency, but then, having been awarded a full scholarship to Gallaudet, I thought that the University would support me during my studies. The majority Deaf faculty (and hearing teachers who taught me) did!

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In the second video, the patient, “Stacy” (a real patient portrayed by a postgraduate student of Dr. Linehan’s), says vocational rehabilitation encouraged her to apply for social security (likely Supplemental Security Income, the program for disabled people that keeps them in poverty and hasn’t been updated since 1972). This is failure on the part of any vocational rehabilitation office to suggest that people with disabilities should just be on the dole. It runs contrary to the point of vocational rehabilitation.

Dialectical Behavior Therapy Wants To Get People Off Supplemental Security Income & Related Public-Disability Programs, Too!

The goal of DBT® is to help folks build lives worth living. But too many are anxious or discouraged from pursuing work. Fortunately, last month, Guilford Publications released two new publications, both of which I highly recommend.

Disabled and Employed: Not Ironic, Just An Introject Shift!

Working any job requires training, respect, and equal opportunity. It starts with access to higher education or skills-training programmes, and there is an open-caption film Open The Door, Get ‘Em A Locker: Educating Nursing Students with Disabilities that follows the journey of a nursing student who uses a wheelchair and service-dog through her nursing-school and employment journey.

Work “Stamina”

Transitioning from subsisting in abject poverty from SSI and/or SSDI takes time. The most important skill is stamina. But, in their DBT Next Steps Clinician’s Manual: Building A Life Worth Living, authors Katherine Anne Comtois, Adam Carmel, and Marsha M. Linehan write in their first chapter “What Is Beyond the Crisis?” on page four the following:

[W]hen the right contingencies are in place and DBT clients practice exposure by applying for jobs and start working, they generally find that after a few weeks of building up “work stamina,” working is quite manageable. In fact, many clients have noted it is less stressful than being disabled.

Resources for Implementing DBT® Next Steps and ACES in Vocational Rehabilitation

Concerned About Customers Losing Long-Term Support Services… ?

Don’t! (One of my Community Placement Agency employment specialists actually called my house phone, which has always had the same line number since I’ve lived in Seattle, me to worry about this on or around June 12, 2019). If Medicaid is paying for their Personal Attendants (which they most likely are) remember that Medicaid is a discrete program with different rules and practices in each jurisdiction. Your job at Vocational Rehabilitation is to assist people in meeting their vocational goals, not to worry about health policy! But if you’re curious, there’s a specific policy at the federal level for continued Medicaid eligibility when working with a disability.

The same Community Placement Agency employment specialist privately-messaged me on my personal Facebook on or around June 19, 2019. By far my favorite HIPAA violation to happen to me…at least so far that I know of.

List of Experiences With Vocational Rehabilitation at the SeaTac Office

I think we should meet with your supervisor to discuss being transferred to a new Vocational Rehabilitation Counselor. Since working together in March 2018, while you’ve been drawing a annual state salary of $70,000 or more, I have had to do the following:

  1. Send you a video explaining what the actuary profession is, and that people have to get a four year degree AND take exams AND usually do an internship at the same time
  2. Get my own Community Based Assessment for call center experience with Puget Sound Dispatch, something a Community Placement Agency should do
  3. Someone from my CPA message me on my personal Facebook and had you make excuses for it
  4. Been hit by a sheriff and subject to inappropriate questions about the legal process by you and Bill Youngman (AT guy)
  5. Had no fewer than eight personal care attendants who all make more than I do,
  6. Have been the subject of an unprofessional, whiny neuropsychologist testing who failed to stay within the scope of his practice during his written assessment
  7. Have had my room’s orderliness criticized on a Zoom call about Assistive Technology
  8. Have experienced unprofessional conduct detailed in the attached e-mails and been made to feel that I’ve done something wrong by analyzing it. I didn’t threaten to go to David Knopes’ licensing board, although not staying within the scope of his practice is reason enough to do so.
  9. Still having actuarial job descriptions for Seattle sent to me when I don’t have a two-year degree or even one actuarial exam under my belt in a region I utterly despise and want nothing more than to leave.
  10. Had my cultural-linguistic background as a Deaf person pathologized as a neurodevelopmental disorder.

Muething, Thomas. “Re: JOB OPENING/ACTUARIAL ANALYST”. Message to Linda      Pomeroy & Alexis Heck. April 1, 2024. E-mail.

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