Enhanced Work Incentives Counseling Assement

Benefit Offset National Demonstration (BOND) Project

BOND Enhanced Work Incentives Counseling Assessment

Enhanced Work Incentives Counseling Assement

OMB: 0960-0785

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Ap 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 Typeapplication/pdf
File TitleAppendix M: Enhanced Work Incentive Assessment Tool
AuthorWoodM
File Modified2010-09-29
File Created2010-09-29

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