1 Running head: CAREER ASSESSMENT PAPER
9 CAREER ASSESSMENT PAPER
CAREER DEVELOPMENT PAPER
( I do not count off for this, but want you to understand how to create a title page correctly)
The purpose of this evaluation is to determine if Ms. Smith has the physical ability to do even sedentary work on a full-time and continuing basis. The process used in this evaluation are clinical interview with the client, a review of medical and pharmacy records, a study of vocational history and education, and a professional impression of the likelihood that a person with the physical limitations of the client can sustain gainful employment without work place accommodations and/or further education and training. Additionally, this evaluation will provide recommendations to the client regarding physical and mental wellness and referrals to medical, psychological, and vocational training providers.
The client, Sue Smith requested a vocational evaluation to determine if there is any work that she would be able to do on a full-time and continuing basis. Currently, she is not working and has not worked at all since January 31, 2013 when she resigned her position of Store Manager for T-Mart, Inc. She states the reason she left her job is due to the severe pain that prevents her for fulfilling her work duties and responsibilities as they need to be. Ms. Smith reports that she has been unable to perform her job since her total right hip replacement March 19, 2012. She did return to work after a short medical leave and although her pay reflects substantial gainful activity, her work week was extending because she could not fulfill the standing requirements of the job and therefore could not sustain an eight-hour day. Her job as a manager allowed her the flexibility to schedule herself to come in additional days so that she could meet the essential functions of the job. She continued this process until August of 2012 when she began having difficulty with edema and pain in her left knee. Since August, she has not been able to complete a typical 40-hour work week and her salary was paid because of accrued medical and personal leave she could use to supplement her hours. Dr. Parker and White’s records support that Ms. Smith has significant lower extremity limitation and Dr. White has told her she will need to have a total left knee replacement
Background and Vocational History
Sue Smith is currently a 53 year-old, white female who is 5’10” tall and weighs approximately 230 pounds. She resides with her husband David Smith at the 189 Lucky Lane, Nettleton, MS. 38823. They have legal custody of their 11-year-old grandson Austin, who also resides at this address. Mr. and Ms. Smith have two adult children who do not live in the home. This is a one story, 3-bedroom ranch style home with no steps and the bathroom is equipped with handrails for both the shower and the toilet. Ms. Smith has a high school equivalent education and no other vocational training.
Ms. Smith began work at age 15 and remained employed until January 31, 2013 when her condition became so severe she could no longer continue in her job. Vocational history for the past fifteen years includes the following:
1995-1998 Retail Cashier and Stocker T-Mart Inc. Tupelo, MS
In this job, Ms. Smith operated a cash register, stocked merchandise, and maintained the store and store grounds. The physical demands of this job required Ms. Smith to stand during her eight-hour shift, left and carry items weighing 20 pounds on a frequent basis and 50 pounds on an occasional basis as well as exerting weights more than 50 pounds on more than an occasional basis. The postural requirements for this job included the ability to frequently balance, stoop, kneel, twist, squat, and bend, and occasionally climb and crawl. Additionally, this job required frequent handling, fingering, feeling, and reaching with occasional overhead work with both arms. The mental demands of this job is semi-skilled work, in a high-stress and high pace environment, with frequent contact with the public. In review of the Dictionary of Occupational Titles classifies this work as Variety Store Stock clerk DOT# 299-367-014 it is listed at the heavy exertion level with a skill level of 4 making this semi-skilled work (https://occupationalinfo.org, 1994)
Jan. 1999- Sept. 1999 Sewing Machine Operator People Loungers Nettleton, MS
In this job, Ms. Smith operated a sewing machine in a furniture plant. Her duties in this job are consistent with the job described in the Dictionary of Occupational Titles. She had to operate a sewing machine to join cut fabric parts to fabricate upholstery coverings for household furniture. The DOT # 780-682-018 classifies this work at the light exertion level with a semi-skill level of 4. https://occupationalinfo.org, 1994).
Oct. 1999-2001 Kitchen Supervisor Avonlee Tupelo, MS
The work Ms. Smith performed in this position is consistent with the description in the DOT which identifies the duties and responsibilities as supervises and coordinates activities of food preparation, kitchen, pantry, and storeroom personnel and purchases or requisitions foodstuffs and kitchen supplies; Plans or participates in planning menus, preparing and apportioning foods, and utilizing food surpluses and leftovers; ensures cleanliness of kitchen and equipment; and tastes, smells, and observes food to ensure conformance with recipes and appearance standards; supervises workers engaged in inventory, storage, and distribution of foodstuffs and supplies. The DOT # for this job is 319-137-030 and is classified at the medium exertion level with a 7 skill level (https://occupationalinfo.org, 1994)
2002-2005 Cashier/Cook Brewer Groc. Shannon, MS
Both of these jobs required the same type of work that Ms. Smith performed in her work as stock clerk. She was expected to operate a cash register, stocked merchandise, and maintained the store and store grounds. In addition, she was required to cook fast food and menu items. The physical demands of these jobs are more consistent with the duties and responsibilities of a variety stock clerk and cook. The variety stock clerk is identified above and the job of cook is classified with the DOT# 313-374-010 and medium exertion level with a skill level or 5 (https://occupationalinfo.org, 1994)
2005-2013 Store Manager T-Mart Inc. Amory, MS
The Dictionary of Occupational titles does not have a designation for someone who manages a Variety Store. In reviewing the DOT and conducting a number of site visits over the past 20 years with regard to this type of work, it appears that a composite of 2 jobs would more accurately describe this work. The DOT classifies the job title of Store Manager (retail trade) with the DOT # 185-167-046 have a light exertion level and a 7 skill level. This job did require that Ms. Smith manage a retail store engaged in selling specific line of merchandise and she did plan and prepare work schedules and assigns employees to specific duties. However, that is where the description or duties ends. Ms. Smith’s work is more accurately reflected by job title of Department Manager associated with DOT # 299-137-010 which also has a skill level of 7. The duties that Ms. Smith performed are consistent with this job description in that she had to supervise and coordinate activities of workers in department store; Interview job applicants and evaluate worker performance to recommend personnel actions such as hiring, retention, promotion, transfer or dismissal of workers. Assign duties to workers and schedule break periods, work hours, and vacations. Train workers in store policies, department procedures, and job duties; Order merchandise, supplies, and equipment. Record delivery of merchandise, compare record with merchandise ordered, and reports discrepancies to control costs and maintain correct inventory levels. Inspect merchandise to ensure it is correctly priced and displayed. Recommend additions to or deletions of merchandise to be sold in department. Prepare sales and inventory reports. Listen to customer complaints, examines returned merchandise, and resolves problems to restore and promote good public relations. In addition, Ms. Smith had to perform the duties of cook for the store and maintain the store and its grounds.
Strong Campbell Interest Inventory
The Strong Interest Inventory® assessment is one of the world’s most widely respected and frequently used career planning tools. It has helped both academic and business organizations develop the brightest talent and has guided thousands of individuals—from high school and college students to midcareer workers seeking a change—in their search for a rich and fulfilling career.( https://www.psychometrics.com/wp-ontent/uploads/2015/04). The results for Ms. Smith on this measure include the following:
· Likes to work with animals, tools, or machines; generally avoids social activities like teaching, healing, and informing others;
· Has good skills in working with tools, mechanical or electrical drawings, machines, or plants and animals;
· Values practical things you can see, touch, and use like plants and animals, tools, equipment, or machines; and
· Sees self as practical, mechanical, and realistic.
· Likes to do things to help people — like, teaching, nursing, or giving first aid, providing information; generally, avoids using machines, tools, or animals to achieve a goal; However, in Ms. Smith cases, she reports in the clinical interview that she does enjoy using these things.
· Is good at teaching, counseling, nursing, or giving information;
· Values helping people and solving social problems; and
· Sees self as helpful, friendly, and trustworthy.
· Likes to work with numbers, records, or machines in a set, orderly way; generally avoids ambiguous, unstructured activities
· Is good at working with written records and numbers in a systematic, orderly way;
· Values success in business; and
· Sees self as orderly, and good at following a set plan. (Holland, 1997)
The Myers-Briggs Type Indicator (MBTI)
The MBTI and Myers-Briggs concepts of Personality Type can help individuals recognize how they interact with their inner and outer world, how they relate to others, how they make decisions, and how they organize their thoughts. Research has shown that many of the different Personality Types tend to have distinct preferences in their choice of careers. We have incorporated observations of each type’s character traits which affect career choice along with some suggestions for possible directions. We have also included lists of actual careers which the various types have chosen in their lives. ( http://www.personalitypage.com/careers.html)
Understanding your Personality Type can assist your career development in a number of ways. It can help you select a career field that is a good fit for your personality make-up. It can increase your awareness of your learning style so you can better benefit from career related education. Understanding your personality preferences can help you better manage Job challenges that inevitably rise their ugly heads during the course of our career. Knowing your Personality Type, and especially knowing the kind of detailed information a Step II MBTI report can provide, will aid you in a job search, both in marketing yourself and in evaluating opportunities that arise. ( http://www.personalitypathways.com/article/career-plan.html). The results for Ms. Smith show that she is an ESFJ. This indicates the following characteristics regarding her personality.
Characteristics of this type include the following:
· Can be depended on to follow things through to completion
· Enjoy creating order, structure and schedules
· Enjoy interacting with people
· Warm-hearted and sympathetic
· Tend to put others’ needs above their own
· Very good at giving practical care
· Very cooperative, good team members
· Practical and down-to-earth
· Value peaceful living and security
· Enjoy variety, but work well with routine tasks
· Need approval from others
Although Ms. Smith has other physical problems, her main issues are with her lower extremity limitations and pain management. Ms. Smith’s medical history is significant for degenerative disc and joint disease, total right hip replacement, and left knee malfunction which will require a total knee replacement. Because of problems with both lower limbs, Ms. Smith cannot stand and/or walk 6 hours out of an 8-hour work day or equivalent schedule.
Furthermore, due to her right total hip replacement she cannot perform even occasional postural demands of work such as climbing, stooping, crouching, kneeling, crawling, bending, squatting, or twisting. She must avoid concentrated exposure to environmental elements such as gas, dust, fumes, strong odors, and exposure to extreme heat and cold because of her COPD. She has some limitations with her right hand which would limit her ability to frequently handle, finger, and manipulate things. Given these limitations, Ms. Smith would need to find sedentary work that allowed for a sit/stand option where she could sit for 20 minutes, stand for 10-20 minutes and alternate sitting and standing at her discretion. She would also need to be allowed to recline at least 3 times a day for 20 minutes at a time to avoid problems with left leg edema. In addition, she would need to work at a job that did not require frequent use of her right, dominate hand and work that did not require that she lift more than 4 or 5 pounds on an occasional basis.
Ms. Smith’s past work is classified at the medium exertion level and she worked long enough to acquire the specific vocational preparation of a skill level of 7. Her past work as Store Manager is classified in the DOT at the light exertion level. However, that classification does not accurately reflect the past work that Ms. Smith did and should not be considered as part of her past work. The work she performed is more consistent with that of a Department Manager which is classified at the medium exertion level. Regardless, in determining transferability of skills from her past work, Ms. Smith does not have skills that would transfer readily and without additional vocational preparation to sedentary work. In analyzing jobs in the local labor market, there are no jobs available that Ms. Smith could do given her limitations and lack of transferable skills. Also, Ms. Smith’s pain has to be managed day by day. Her level of pain is unpredictable depending of prior activity level and weather conditions but she reports that she would miss time away from work on average of at least one day a week. Employers will tolerate absence from the work place no more than 3 days out of a work month. However, in conducting job site interviews with employers, they would be inclined to terminate employment if a worker consistently missed 3 days of work a month. In considering her physical limitations and pain, Ms. Smith could not perform gainful employment on a continuous and consistent basis for 5 days a week. In summarizing Ms. Smith’s work history, predominately her work for the past fifteen years has been done at the medium to heavy exertion level with a 7 skill level.
Review of Medical Records (can use special circumstances)
Ms. Smith’s medical history is significant for the following problems, GERD, COPD, Degenerative joint and disc disease, edema of the right hand and both lower extremities and moderate to severe pain in the right upper extremity, right hip constantly and left hip more than occasionally, and constant severe pain in the left knee. In 1999, Ms. Smith had an arthroscopic procedure performed by Dr. Rice to repair her left knee. Ms. Smith underwent esophageal repair in 2007 and total right hip replacement in March of 2012.
Medical records from Dr. Parker provide evidence of Ms. Smith’s ongoing medical conditions listing in a number of records problems she has with chronic respiratory problems due to her COPD and moderate to severe pain in her back, hips, and knees. On May 11, 2010, x-rays of both hip shows significant arthritis in bilateral hips with the right being worse than the left. Also, in medical records dated May 13, 2011 she was having problems with radiation down her right leg. At that time, she had generalized myalgia and arthralgia (muscle and joint pain) of her shoulders, hands, and knees. Dr. Parker ordered blood work to rule out rheumatoid arthritis but subsequent records list this condition under prior problems and Ms. Smith has had at least one episode in the past year of gout which required medication.
Medical records from Dr. White support the problems Ms. Smith reports with regard to pain in her lower extremities. Although the right total hip replacement was successful in correcting the joint problem, Ms. Smith continues to experience significant pain especially when the weather is cold or wet. She manages her pain with prescription pain medication, ice, heat, rest, and elevation. Dr. White’s records also support the need for Ms. Smith to undergo total left knee.
Medical evidence supports Ms. Smith’s allegations of severe pain. In addition to her degenerative joint disease, she has been diagnosed with degenerative disc disease of the spine, osteo and rheumatoid arthritis and has been treated for numerous upper respiratory infections due to COPD. Dr. White’s records indicate that her right hip is healing but Ms. Smith has an abnormal gait and experience problems walking distances longer than 100 feet.
Activities of Dailey Living
The interview took place on May 1, 2013. After a brief introduction of my credentials, the session began. Ms. Smith was cooperative and pleasant and stated she understood the purpose of the interview. Her primary reason for seeking help is to determine if she is eligible for disability benefits from social security and if not what kind of work she would be able to do given her physical limitations and pain. I explained that in order to be eligible for social security disability benefits she would have to prove disability under social security law and that her disability is so severe that she could not do her past work or any work in the local or national economy. To help determine if there is work Ms. Smith could do, we discussed her typical daily routine.
Ms. Smith states that she is able to take care of her personal needs such as bathing, toileting and dressing but she requires the use of hand bars, a shower bench occasionally, and to get dress sitting down. She does the family shopping about once a week but has to have assistance with getting groceries and other items in and out of her vehicle. She also needs help in putting items away that require she bend or stoop. She states that she gets up early, around 5:30 or 6:00 am to get her grandson up and ready for school. She starts her day in a lift chair that reclines in order to keep the swelling from being so bad in her knees and ankles, especially her left knee and ankle. She can do light house work but has to take a break every 20 minutes to sit down due to burning pain in her left knee and pain in her right hip area. She can walk a total of about 300 feet a day but not all at the same time. Her husband prepared a path for her so that she could walk from her back porch to the edge of the yard. The distance is approximately 30 feet and she does this several times a day to help with soreness and stiffness in her legs and feet. Ms. Smith states she does the minimum she has too in order to manage her physical condition. Even with taking these precautions, she still experiences nights when she cannot go to sleep due to discomfort and pain. The lack of sleep affects her ability to focus and concentrate the next day on even routine tasks such as making a shopping lists or gathering ingredients for a recipe. Lack of sleep in combination with her pain medication affects her ability to concentrate and focus on what she is doing for example watching a 30-minute television show or reading a novel.
During this interview, Ms. Smith expressed her sense of loss over her physical condition and sadness in not being able to do what she once did. Ms. Smith states that the heaviest thing she lifts is a 4-pound bag of sugar with an amount heavier than that resulting in pain and difficulty in ambulating if she has to walk. She reports that she does not climb anything except an occasional step if she has to go somewhere that does not have a ramp. She cannot climb a complete flight of steps without it taking a long time. She has to put her “good” leg up and then pull up her right leg so she avoids them if at all possible. Ms. Smith states she cannot stoop, bend, squat, crawl, crouch or twist without severe hip pain. Although, she has had problems with swelling in her hands, as documented in the medical records, she can occasionally handle and finger items without difficulty. However, when her hands swell she has to use ice and heat to help with the edema and pain. Ms. Smith states that she has to avoid gases, fumes, chemicals, and extremes of heat and cold in order to prevent problems with respiratory infections and COPD symptoms. Ms. Smith manages her pain with prescription pain medication, aspirin, ice and heating pad, and elevation. She states that she is never pain free and that some days are better than others depending on the weather and the activities she has done the day before. She reports that she spends approximately half her day, about 4 out of 8 hours in a reclining position to avoid pain and swelling in her left knee as well as pain in her right hip.
Summary and Recommendations
Ms. Smith is a 53-year-old female, approaching advanced age, who has a long, successful work history. Her medical evidence supports her significant physical limitation with regard to joint and disc problems, past and recommended surgeries, COPD, and pain. She cannot return to past work either as she performed it or as it is generally performed in the local and national economy. She does not have skills that will transfer readily or without further vocational preparation to a sedentary position. She would not be able to sustain work for 8 hours a day, 5 days a week on a consistent and continuous basis.
However, Ms. Smith would be able to part-time in a job that would allow her to sit and stand at will. The following are suggestions as to the work Ms. Smith could do for no more than 20 hours a week. The following are suggestions for work that Ms. Smith might be able to do on a part-time basis. The Dictionary of Occupational Titles identifies the jobs in terms of title, number, description, exertional level and specific vocational preparation.
TITLE(s): CLERK, GENERAL (clerical) alternate titles: office clerk, routine
Performs any combination of following and similar clerical duties requiring limited knowledge of systems or procedures: Writes, types, or enters information into computer, using keyboard, to prepare correspondence, bills, statements, receipts, checks, or other documents, copying information from one record to another. Proofreads records or forms. Counts, weighs, or measures material. Sorts and files records. Receives money from customers and deposits money in bank. Addresses envelopes or packages by hand or with typewriter or addressograph machine. Stuffs envelopes by hand or with envelope stuffing machine. Answers telephone, conveys messages, and runs errands. Stamps, sorts, and distributes mail. Stamps or numbers forms by hand or machine. Photocopies documents, using photocopier. (http://www.occupationalinfo.org/).
According to the DOT, this work is classified at the light exertional level indicating requirements that a person should be able to stand and/or sit 6 hours out of an 8-hour day. However, in Ms. Smith’s situation she would need to work no more than 4 hours a day and be allowed to sit and stand as will. In conducting job site analysis on this work, there are industries that will allow for this option. The specific vocational preparation (SVP) is a 3 which indicates semi-skilled work and would be consistent with her past occupational profile where she had acquired and SVP of 7 which is skilled work. According to the US Bureau of Labor Statistics, 2016, the median pay for this job is $14.70 per hour with an annual median income of $30,000. It requires a high school diploma, does not require work experience since person would be trained on the job. There are over 3,000,000 of these jobs in the national economy and it is anticipated that there will be approximately 95,000 openings each year in this job classification. (https://www.bls.gov/ooh/office-and-administrative-support/general-office-clerks.htm)
CODE: 237.367-038 TITLE(s): RECEPTIONIST (clerical) alternate titles: reception clerk The essential function of this job receives callers at establishment, determines nature of business, and directs callers to destination: Obtains caller’s name and arranges for appointment with person called upon. Directs caller to destination and records name, time of call, nature of business, and person called upon. May operate PBX telephone console to receive incoming messages. May type memos, correspondence, reports, and other documents. (http://www.occupationalinfo.org/).
According to the DOT, this job is classified at the sedentary level which requires that a person be able to sit 6 out of an 8-hour day and stand and/or walk for 2 hours out of an 8-hour day. Again, Ms. Smith will need to only work for 4 hours and will need the option to sit and stand at will. In conducting site visits for this job, observations indicate that this job will allow Ms. Smith the sit/stand option. The SVP for this job is a 4 indicating this is a semi-skilled job consistent with Ms. Smith’s past work.
According to the US Bureau of Labor Statistics, 2016, the median pay for this job is $11.70 per hour with an annual median income of $22,000. It requires a high school diploma, does not require work experience since person would be trained on the job. There are over 31000,000 of these jobs in the national economy and it is anticipated that there will be approximately 45,000 openings each year in this job classification. (https://www.bls.gov/ooh/office-and-administrative-support/general-office-clerks.htm).
CODE: 237.367-010 TITLE(s): APPOINTMENT CLERK (clerical) alternate titles: reception clerk
Schedules appointments with employer or other employees for clients or customers by mail, phone, or in person, and records time and date of appointment in appointment book. Indicates in appointment book when appointments have been filled or cancelled. May telephone or write clients to remind them of appointments. May receive payments for services, and record them in ledger. (http://www.occupationalinfo.org/).
According to the DOT, this job is classified at the sedentary level which requires that a person be able to sit 6 out of an 8-hour day and stand and/or walk for 2 hours out of an 8-hour day. Again, Ms. Smith will need to only work for 4 hours and will need the option to sit and stand at will. In conducting site visits for this job, observations indicate that this job will allow Ms. Smith the sit/stand option. The SVP for this job is a 3 indicating this is a semi-skilled job consistent with Ms. Smith’s past work.
I would encourage Ms. Smith to pursue her claim for Social Security Disability benefits. I would suggest looking at the listing of impairments and consider Ms. Smith meet 1.01 Musculoskeletal Impairments, specifically 1.02 which discusses major dysfunction of joints. Ms. Smith’s medical documentation supports problems with her right hip and left knee which meets section A of this listing denoting the involvement of one major peripheral weight-bearing joint. In Ms. Smith’s case, both lower extremities are affected which results in her not being able to ambulate effectively. If this listing does not apply, then I would suggest that given Ms. Smith’s age, education, and lack of transferable skills and that she would be limited to sedentary work, she would be disabled when applying the grid rule for social security benefits. Likewise, Ms. Smith cannot sustain a normal work schedule on a continuing and consistent basis which would prevent her from performing work at any level.
It has been a pleasure working with Ms. Smith. I am convinced that she is unable to do her past work or any work at this time. Even with her left knee repaired, her condition is degenerative and not expected to improve to the point where she could return to substantial work. Even with additional training, she could, at best, work on a part-time basis. Because working is important to her, I would recommend that Ms. Smith contact the Mississippi Department of Rehabilitation Services and discuss the possibility of training for work that would be available given her physical limitations. They could provide her with training for sedentary work and would be able to advocate on her behalf for workplace accommodations and modifications.
Duane Brown (2016). Career information, career counseling, and career development. (11th ed.). Pearson, Boston.
Figler, H., & Bolles, R. N. (2007). The Career Counselor’s Handbook. (2nd ed.) Berkley:
Ten Speed Press.