Burn injury most commonly limits mobility. This results from contractures caused by shortening of tissues or scarring. Burns to the lower extremities may interfere with walking, climbing, or balancing. Those to the upper extremities may interfere with reaching, fingering, and handling. In some cases, upper extremity impairment also results in problems with self-care activities such as eating, dressing, hygiene, and grooming.

Cosmetic disfigurement is also a common result of burn injury. Family members, coworkers, and the public may reject the person. This can present a barrier to employment in occupations requiring interpersonal relationships. Other common functional limitations include:

• Tolerance to extreme heat conditions

• Aesthetic appearance

• Ability to meet the public

• Activities causing trauma/irritation to injured skin and/or joints

• Range-of-motion if joints are affected (see arthritis limitations)

• Self-image

• Employer/peer acceptance

The specific functional limitations must be addressed as they relate to the performance of past jobs or potential future jobs. Cosmetic appearance can be an employment barrier resulting in rejection by coworkers, employers, and the public.

The counselor should assess the extent of functional limitations as they relate to performing past jobs. If unable to perform past work, an assessment must be made as to the individual's potential for further training to qualify for employment consistent with existing limitations.