Best career move for an engineer with RSI?

This question is a bit hard to answer because programming with RSI just means that your input method is different. Which comes with a whole set of challenges, as your question implicitly recognizes, but I'm not sure that it makes much difference as far as your career moves are concerned.

I guess as a start, a big key is to find a job / company culture that promotes an asynchronous workflow more broadly. That way, you're not being forced to bang out a bunch of code under immediate time pressure, which would make having to use voice software feel frustrating. With async, it matters less if your raw input velocity is slowed down relative to someone without RSI, since there's no _immediate_ pressure.

None of that obviates the need to work hard and produce value, of course.