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pdfAp p e n d ix M:
En h a n c e d Wo rk In c e n tive As s e s s m e n t Too l 1
1
QUESTION
Why do you want to work? What are your
concerns? Do you feel your disability is a barrier to
obtaining a job? How?
DOMAIN
Work
Can you use public transportation independently?
Do you drive a car? Current transportation
resources (public, private)? Lines close to home?
Daily Activities
Do you need support with any daily living activities
(dressing, cooking, eating, cleaning, grocery
shopping, phone calls)? Is your present living
arrangement stable, permanent, accessible? With
whom do you reside?
Daily Activities/Family
What benefits/services do you currently use for
support? Do you understand the impact that
working will have on your benefits?
Financial
Have you graduated from High School? Other
educational or training experience? What is your
computer experience? Do you have access to a
computer?
Work
Describe your general health and any physical,
emotional, and/or secondary disabilities. Describe
your mobility/ambulation, motor skills and any
adaptive technologies currently used and/or
needed.
Health/Mental health/Daily activities
What is your primary mode of communication?
What is your primary language? Do you have
access to email? Do you use a mobile phone?
Text?
Daily activities
Describe your support system (family, friends,
service providers, affiliations). Regular groups you
belong to? i.e.; church, choir, book club, athletic
club/recreational sport; community theater?
Family
What is your employment goal?
Work
Previous work experience?
Work
What skills do you feel you need to obtain to reach
your employment goal? (i.e. Job Search skills?
Interviewing? Resume writing?)
Work
Do you feel your skills are competitive for today’s
market?
Work
Transcen Inc. pre-employment checklist
1
QUESTION
Would work experience help you achieve your
goal?
DOMAIN
Work
Ideal type of work environment?
Work
Reasons for leaving last job?
Work
2
File Type | application/pdf |
File Title | Appendix M: Enhanced Work Incentive Assessment Tool |
Author | WoodM |
File Modified | 2010-09-29 |
File Created | 2010-09-29 |