How to Create A Successful Career As A COTA

Are you seeking new COTA career opportunities? The Certified Occupational Therapy Assistant field offers a wide range of options to fit nearly every passion and lifestyle.

What is the best career path for a COTA? Let’s take a look at the breakdown of COTA career paths to consider.

Common Types of COTA Career Opportunities

Before you can choose the best career path for a COTA, you need to understand the different paths available. Below is a list of the many fields in which a COTA can excel:

1. Hospitals or Outpatient Rehabilitation Programs

Working as a COTA hospital employee means supporting patients either within the hospital setting or at their outpatient rehabilitation programs.

Hospital jobs can offer more stability than other COTA health careers due to the regular hours and long shifts.

Working in a hospital may be a good fit if you enjoy:

  • Structure
  • Being “on-the-go”
  • Working with large teams

2. Schools and School Districts

As more services are being offered for students with disabilities, COTAs are being utilized in schools and school districts throughout the country. They are familiar with three key things that every child with a disability must face:

  • Emotional effects
  • Social effects
  • Physiological effects

Often included on the special services team, COTAs help students reach their full potential by collaborating with:

  • School psychologists
  • Social workers
  • Teachers
  • Parents

COTA career opportunities in a school or school system provide a medium to high level of stability as the position is often full-time. In some cases, the COTA will serve multiple schools on an as-needed basis.

3. Skilled Nursing Facilities and Nursing Homes

Both skilled nursing facilities and nursing homes provide a stable career path for COTAs.

In both cases, COTAs customize treatment plans to each individual. It is common to help residents excel in self-care skills like personal hygiene, feeding, and dressing.

COTAs work with OTs and other staff to:

  • Modify the person’s environment for ultimate independence
  • Facilitate skill-building and participation in the center’s activities
  • Obtain equipment to assist with these activities

4. Home Health Care

Home health care jobs for COTAs can be supportive administrative roles within an agency. Responsibilities can include working with the OT to:

  • Improve efficiency among staff
  • Implement new administrative requirements
  • Optimize outcomes for patients

Additionally, there is a need for home health care support where COTAs work directly with patients in their residences. Depending on the injury or diagnosis, responsibilities will vary widely from patient to patient.

Other Types of COTA Health Careers

Below are a series of COTA health careers that provide a unique way to make the most of your certification.

5. Business Ergonomics

COTA career opportunities relating to ergonomics often come in the form of analysis and design. Depending on the type of job, working in this niche can range from very stable to consultant work. This COTA career path will take you to:

  • Factories
  • Warehouses
  • Stores
  • Office buildings
  • And potentially everywhere else business is conducted

Ergonomic work environments are designed to maximize employees’ strengths and productivity while minimizing potential limitations.

The overall goal is to utilize COTA skills to design environments that promote safety and comfort while preventing injury.

How does a COTA support these objectives? The main ways are:

  • Analyzing job functions and determining candidate’s ability to perform
  • Identifying hazards, especially in physically demanding work environments
  • Recommend modifications to any equipment, furniture and/or flow of the environment
  • Provide injury prevention and stress management education
  • Recommend ways to comply with the Americans With Disabilities Act

6. In-Home Environmental Modification

An in-home environmental modification is the creation of a safe and accessible environment.

Skills like the ability to modify, adapt and change are high on the list for a COTA career path in an environmental modification. This field is more important than ever as the desire to stay at home vs. move to assisted living grows among older adults.

In most cases, in-home environmental modification work will be as-needed, making the COTA somewhat of a consultant. While this is not the most stable of all the COTA career opportunities, there are many pros, such as:

  • The flexibility to make your own schedule
    Working with a staffing agency ensures your work is steady while still offering you desired flexibility.
  • Travel opportunities
    Work within your immediate community or accept jobs throughout the state and country.
  • Patient advocacy
    Work to educate the patient, their family and potentially their providers on why some accommodations are necessary.
  • Community networking
    Make valuable connections in your community as you work to connect patients with service providers such as architects, contractors and interior designers.

7. Community Mobility

Mobility is the cornerstone of a COTA’s career. A field that may be overlooked when describing COTA career opportunities is Community Mobility.

Specifically, there is a specialty practice of driving and mobility with the occupational therapy field. This field includes the Specialty Certification in Driving and Community Mobility or SCDCM.

According to the American Occupation Therapy Association, “SCDCM focuses on practitioners enabling a client to be mobile in his or her community environment, whether that is via driving, public transportation, walking, school bus, etc.”

The SCDCM trains COTAs to work in a variety of areas throughout the community such as:

Driving or riding in cars

  • Teaching the use of adaptive equipment
  • Determining if a patient is fit to drive
    Providing drive-specific rehabilitation services
  • Advocating for the patient legally regarding court decisions about continuing to drive
  • Teaching teens with disabilities to drive

Public transit options

  • Training someone in a method of transportation he/she is not familiar
  • Consulting with transit companies, city officials or policymakers to advocate for mobility-related issues
  • Facilitating traffic safety programs geared toward those with disabilities


  • Working with the city to ensure ADA compliance via curb-cuts, textured ramps, etc.
  • Providing patient guidance on best routes and times of day

As you can see from the types of COTA career opportunities outlined above, there is a COTA health careers path for every individual with a passion for Occupational Therapy.

Choosing the Best Career Path for COTA

Following the right COTA career path comes down to determining the “barrier” that most intrigues you.

Consider asking yourself a series of questions to narrow down your areas of interest:

  • What drew me to occupational therapy?
  • When do I feel most helpful and/or productive in my work? What exactly am I doing when I feel that way?
  • Do I enjoy a regular schedule with strict hours or can I trade stability for flexibility?
  • Do I enjoy working with patients or in an administrative role?
  • Is traveling for work something that intrigues me?

Next, take a look at the top paying states for the COTA profession.

Top Paying States and Salaries for COTA | COTA Career Opportunities

Once you’ve taken all factors into consideration, you can build a career that’s right for you.

Have a question about becoming a COTA? Reach out to us!


Explore Your Career Options



Choose Your Adventure
Nursing | Allied
Per Diem

Per Diem

Design Your Schedule
Flexibility | Consistency |


Advance Your Career
Opportunity | Support |