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«IDENTIFICATION OF CORE VARIABLES TO BE CONSIDERED IN AN ASSESSMENT OF VOCATIONAL EARNING CAPACITY IN A LEGAL-FORENSIC SETTING: A DELPHI STUDY By RICK ...»

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IDENTIFICATION OF CORE VARIABLES TO BE CONSIDERED IN AN ASSESSMENT

OF VOCATIONAL EARNING CAPACITY IN A LEGAL-FORENSIC SETTING:

A DELPHI STUDY

By

RICK ROBINSON

A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL

OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT

OF THE REQUIREMENTS FOR THE DEGREE OF

DOCTOR OF PHILOSOPHY

UNIVERSITY OF FLORIDA

© 2011Rick Robinson

ACKNOWLEDGMENTS

I thank Dr. Chad Betters and Dr. Linda Shaw for their encouragement to pursue doctoral level study in the Rehabilitation Science field. If not for their encouragement, I may have still been talking about entering a doctoral program versus standing at the finish line of this incredible academic journey.

I am forever grateful to my doctoral committee members. I am most thankful to my committee chair, Dr. Jamie Pomeranz for being an incredible mentor, colleague and friend. His guidance and advice always led me down the path of greatest success. Dr. Mary Ellen Young was always ready and willing to provide input and guidance on qualitative research methods and design. I thank her for sparking this interest that will continue to be a core methodology in my future research endeavors. From my earliest contact with Dr. Jay Rosenbeck in the rehabilitation science foundation’s class, his passion for rehabilitation research and application was evident. His gentle encouragement and unyielding commitment to his students and to my doctoral studies is greatly appreciated. I thank Dr. David Miller for his support of my doctoral studies and for his ability to make my qualitative mind think in quantitative terms.

To my many colleagues and peers I have consulted with during this journey, and my colleagues around the nation who agreed to participate in this research, I will be forever grateful.

Special thanks are extended to Dr. Mike Moorhouse; Dr. Laura Perry; Dr. Horace Sawyer and Dr. Mary Barros-Bailey. To Margaret Odom, I am thankful for her steadfast guidance which was instrumental in navigating the complex waters of doctoral level study. Lastly, I thank the boards of directors for the International Association of Rehabilitation Professionals and the American Board of Vocational Experts for their assistance in recruitment for my dissertation research. Their support was key to the success of this study.

Lastly, to my wife Kimberly who offers unconditional love, emotional support and encouragement to me every day. Her encouragement and willingness to support my dreams has always been unwavering. It is through her strength as a woman, mother and wife that we have been able to achieve success never thought possible when we started life’s journey together some 25 years ago.

–  –  –

ACKNOWLEDGMENTS

LIST OF TABLES

LIST OF FIGURES

ABSTRACT

1 INTRODUCTION

Background

Models of Vocational Assessment

Earning Capacity Evidentiary Standards

Vocational Earning Capacity and Forensic Damages

Research Question

2 LITERATURE REVIEW

Models of Disablement

Vocational Capacity Determination

Genesis and Evolution of Vocational Rehabilitation and Evaluation

Vocational Capacity Determination Venues

Venue One: Workers Compensation Expert Consultation

Venue Two: Social Security Expert Consultation

Venue Three: Civil Litigation Forensic Consultation

Standard of Evidence

Models of Vocational Earning Capacity Assessment

RAPEL

Shahnasarian Model / Method

Deutsch / Sawyer Model

Labor Market Access Model

Dillman’s Loss of Earning Capacity Model

McCroskey Vocational Quotient System (MVQS)

Rehabilitation Case Analysis Method (RECAM)

Economic Foundations of Earning Capacity Assessment

Economic Present Value

Comparison of Consensus Methods

Nominal Group Technique

National Institutes of Health Consensus Development Conference

Glaser Approach

Delphi Method

Rationale for Use of the Delphi Method

The Delphi Technique and Process

Application of the Delphi Method to Rehabilitation Research

Review of Delphi Studies in the Field of Rehabilitation

3 METHODOLOGY

Research Question

Study Design

Expert Panelist Selection

Expert Panelist Incentive to Participate

Delphi Procedure

Round 1

Round 2

Round 3

Consensus

4 RESULTS

Panel Qualification

Panel Demographics

Delphi Round 1

Delphi Round 2

Delphi Round 3

Domains of Accepted Variables

Socioeconomic Domain

Cultural Domain

Education Domains

Past Work Domains

Job Acquisition and Maintenance Domain

Military Service Experience Domain

Language Skills Domain

Medical History and Treatment Domain





Medical-Functional Capacity

Behavioral Health Domain

Household Activities Domain

Activities of Daily Living Domain

Avocational Activity Domain

Transportation Domain

Financial Domain

Economic Domain

Psychometric Instrumentation

Transferable Skills

Labor Market Statistical Information Domain

Labor Market Sampling Domain

Work Life Participation

Rehabilitation Planning and Services Domain

Professional Resources Domain

Legal Jurisdiction Domain

5 CONCLUSIONS

Overview of Significant Findings

Delphi Study

Items Unique to Legal-Forensic Settings

Economic variables

Work life participation variables

Legal jurisdiction variables

Unique Domain Findings

Labor marketing sampling domain

Cultural domain

Results and the ICF Model

Assumptions

Limitations of the Study

Implications of the Study

Data Modeling

Self-Assessment

Training & Education

Recommendations for Future Research

APPENDIX A RECRUITMENT LETTER TO IARP

B RECRUITMENT LETTER TO ABVE

C PANELIST QUALIFICATION QUESTIONAIRE

D DELPHI ROUND 1 QUESTIONAIRE

E BETA REVIEWER FEEDBACK AND ACTIONS TAKEN

F QUALITATIVE CONTENT ANALYSISAUDIT TRAIL

G DELPHI ROUND 2 QUESTIONAIRE

H DELPHI ROUND 3 QUESTIONAIRE

LIST OF REFERENCES

BIOGRAPHICAL SKETCH

–  –  –

2-1 Worker traits considered in social security claim adjudication

4-1 Expert panel practice location

4-2 Expert panel highest degree held

4-3 Expert panel credentials

4-4 Expert panel memberships

4-5 Expert panel years of practice

4-6 Expert panel areas of practice

4-7 Expert panel percent litigated vs. non-litigated

4-8 Expert panel percent of litigated cases retained by the defense

4-9 Expert panel testimony experience

4-10 Variables with mean greater than 5 and interquartile range from 0 to 2

4-11 Variables with mean less than 5 and / or interquartile range greater than 2

4-12 Percentage of variables accepted for each domain

4-13 Socioeconomic variables accepted

4-14 Cultural variables accepted

4-15 Education-compulsory (k-12) variables accepted

4-16 Education-vocational and apprenticeship variables accepted

4-17 Education-higher education (college) variables accepted

4-18 Education-general variables accepted

4-19 Past work experience-variables specific to the job accepted

4-20 Past work experience-variables specific to the employee accepted

4-21 Past work experience-variables specific to the employer accepted

4-22 Job acquisition and maintenance variables accepted

4-23 Military service experience variables accepted

4-24 Language skill variables accepted

4-25 Medical history and treatment variables accepted

4-26 Medical-functional capacity variables accepted

4-27 Behavioral health variables accepted

4-28 Household activity variables accepted

4-29 Activities of daily living variables accepted

4-30 Avocational activity variables accepted

4-31 Transportation variables accepted

4-32 Financial variables accepted

4-33 Economic variables accepted

4-34 Psychometric measurement variables accepted

4-35 Transferable skill variables accepted

4-36 Labor market statistical information variables accepted

4-37 Labor market sampling variables accepted

4-38 Work life participation variables accepted

4-39 Rehabilitation planning and service variables accepted

4-40 Professional resource variables accepted

4-41 Legal jurisdiction variables accepted

–  –  –

3-1 Level of importance rating scale

5-1 Proposed vocational and rehabilitation assessment model

–  –  –

IDENTIFICATION OF CORE VARIABLES TO BE CONSIDERED IN AN ASSESSMENT

OF VOCATIONAL EARNING CAPACITY IN A LEGAL-FORENSIC SETTING:

A DELPHI STUDY

–  –  –

Chair:Jamie Pomeranz Major: Rehabilitation Science The goal of this study was to assess a potential set of items considered core to the assessment of vocational earning capacity in a legal-forensic setting. Despite numerous published methods and protocols addressing assessment of vocational earning capacity, there is considerable variability among vocational consultant conclusions and opinions. A high level of variability in opinion and methodology is problematic within legal-forensic settings.

A three-round Delphi expert consensus building methodology was utilized in this study.

The expert panel size from round one to round three was 47 and 38 respectively, yielding a response rate over all three rounds of expert input of 81%. This study resulted in identification of 232 discrete variables viewed by vocational consultants as core to the assessment of vocational earning capacity in a legal-forensic setting. Variables were distributed across 29 distinct domains. The findings of this study provide empirical support for a proposed set of core variables to be used to assess vocational earning capacity. Implications of study findings and recommendations for future research are included.

–  –  –

The foundation of the modern day vocational rehabilitation profession can be traced back to 1920 with the enactment of the Smith-Fess Act (Roessler & Rubin, 2006). Also known as the Civilian Vocational Rehabilitation Act, the Smith-Fess Act extended vocational rehabilitation services to civilian individuals with a physical disability (Rubin & Roessler, 2008). Since inception of the vocational rehabilitation profession, substantial literature contributions have been made to describe factors and issues relevant to determining a person’s vocational and earning capacity. Farnsworth, Field, Field, Griffin, Jayne, Johnson et al. (2005) wrote that the process of vocational evaluation draws upon clinical skills from the fields of psychology, counseling and education. Specific skills include file review, diagnostic interviewing, psychometric testing, clinical observation, data interpretation and career counseling (Farnsworth et al., 2005). Vocational rehabilitation counselors apply these skills when conducting a vocational evaluation.

Since inception, the role and function of the vocational rehabilitation counselor has been a topic of debate. Early rehabilitation counseling pioneers advocated for a division of labor with respect to rehabilitation scope and function as “rehabilitation counselors” and “rehabilitation coordinators” (Patterson, 1957). This arbitrary bifurcation was not practical as rehabilitation counselors required a complex continuum of skills that involved counseling, evaluation and coordinating functions (Hershenson, 1990, 1998; Koch, Hennessey, Niese, Tabor, & Petro, 2004;

Leahy, Chan, & Saunders, 2003). Over time, the role, function and scope of practice of rehabilitation counselors has evolved into a well-established profession with established methods, protocols and standards of practice (Leahy et al., 2003; Rubin & Roessler, 2008).

Rubin and Roessler (2008) described the rehabilitation counseling process as involving four sequential steps that include evaluation, planning, treatment and termination. The foundation of the rehabilitation counseling process rests upon the initial vocational evaluation and exploration of vocational options by the counselor. It is the initial evaluation that establishes the rehabilitation parameters for the remaining phases of the rehabilitation process.

Inherent to the vocational rehabilitation process, and in particular, the vocational evaluation phase, is a focus on exploring variables such as an evaluee’s vocationally relevant capabilities, skills and interests, both presently and prospectively (Rubin & Roessler, 2008). The variables in composite make up the person’s unique vocational profile. With respect to assessment of future earning capacity, the rehabilitation process is used to determine vocational options for which a person is qualified or may be able to be trained. Wages earned from identified vocational options represent the person’s vocational earning capacity given their unique vocational profile (Owings, Lewis, Streby, & Hildebrand, 2007). It is the rehabilitation process and framework that has given way to the vocational rehabilitation counselor’s contemporary role as the generally accepted expert in earning capacity assessment (Owings et al., 2007).

–  –  –

Isaacson (1977) described four broad categories of variables that influence workers and their careers. These categories include psychological, physical, sociological and economic factors. The first two categories, psychological and physical, include consideration of aptitudes;



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