There has been much discussion on several groups about an entirely accessible backup utility with regard to actually taking a full system image backup.  I have yet to find a backup and recovery utility that is 100% accessible in all respects, but Macrium Reflect, Version 7, is 100% accessible for creating a full system image backup for "the typical user" who keeps the typical disc arrangement under Windows where all OS files and user data files are on the C: drive.

Given what's been happening over the last several days with the Windows 10 Version 1809 feature update it is really critical to take a full system image backup before it is applied.

Here's the link to download the step-by-step instructions, along with notes about setting things up, in MS-Word format:

Using Macrium Reflect With a Screen Reader To Take a Full System Image Backup

You should be presented with a Save dialog shortly after activating the link. 

I went through this process from beginning to end using NVDA to control everything.  I cannot imagine that things should be different in JAWS and possibly even Narrator.  If there are any significant differences that you encounter please share them on this topic.
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Brian - Windows 10 Home, 64-Bit, Version 1803, Build 17134  

    The psychology of adultery has been falsified by conventional morals, which assume, in monogamous countries, that attraction to one person cannot co-exist with a serious affection for another.  Everybody knows that this is untrue. . .

           ~ Bertrand Russell